IMAGE  EVALUATION 
TEST  TARGET  (MT-S) 


1.0 

I^LjjS    |2.5 

■  50     ""^        ■■■ 

tii  Ui    IIII22 

I.I 

m 

|,.25 

m  m 

6" 


P? 


/a 


/ 


7 


'/ 


Photographic 

Sciences 

Corporation 


33  WEST  MAIN  STREET 

WEBSTER,  N.Y.  14580 

(716)  872-4503 


''^V^ 


:  ;■: 


^\^ 


CIHM/ICMH 

Microfiche 

Series. 


CIHM/ICMH 
Collection  de 
microfiches. 


Canadian  Institute  for  Historfcal  Microreproductions  /  Institut  canadien  de  microreproductions  historiques 


:  I- 


Technical  and  Bibliographic  Notes/Notes  techniques  et  bibliographiques 


The  Institute  has  attempted  to  obtain  the  best 
original  copy  available  for  filming.  Features  of  this 
copy  which  may  be  bibliographically  unique, 
which  may  alter  any  of  the  images  in  the 
reproduction,  or  which  may  significantly  change 
the  usual  method  of  filming,  are  checked  below. 


D 


D 


D 
D 


D 


D 


Coloured  covers/ 
Couverture  de  couleur 


I      I    Covers  damaged/ 


Couverture  endommag^e 

Covers  restored  and/or  laminated/ 
Couverture  restaurie  et/ou  peliicuide 

Cover  title  missing/ 

Le  titre  de  couverture  manque 


I      I    Coloured  maps/ 


Cartes  g^ographiques  en  couleur 

Coloured  inl<  (i.e.  Oiher  than  blue  or  black)/ 
Encre  de  couleur  (i.e.  autre  que  bleue  ou  noire) 


I      I    Coloured  plates  and/or  illustrations/ 


Planches  et/ou  illustrations  en  couleur 


Bound  with  other  material/ 
Reli6  avec  d'autres  documents 


Tight  binding  may  cause  shadows  or  distortion 
along  interior  margin/ 

Lareliure  serrde  peut  causer  de  I'ombre  ou  de  la 
distortion  le  long  de  la  marge  int^rieure 

Blank  leaves  added  during  restoration  may 
appear  within  the  text.  Whenever  possible,  these 
have  been  omitted  from  filming/ 
II  se  peut  que  certaines  pages  blanches  ajout^es 
lore  d'une  restauration  apparaissent  dans  le  texte, 
mais,  lorsque  cela  6tait  possible,  ces  pages  n'ont 
pas  6t6  filmies. 

Additional  comments:/ 
Commentaires  suppldmentaires; 


L'Institut  a  microfilm^  le  meilleur  exemplaire 
qu'il  lui  a  6t6  possible  de  se  procurer.  Les  d6tails 
de  cet  exemplaire  qui  sont  peut-dtre  uniques  du 
point  de  vue  bibliographique,  qui  peuvent  modifier 
une  image  reproduite.  ou  qui  peuvent  exiger  une 
modification  dans  la  m6thode  normale  de  filmage 
sont  indiquAs  ci-dessous. 


JY 
to 


I      I    Coloured  pages/ 


D 
D 
0 
D 
0 

n 


D 


This  item  is  filmed  at  the  reduction  ratio  checked  below/ 

Ce  document  est  filmd  au  taux  de  rMuction  indiquA  ci-dessous. 

10X  !4X  18X  22X 


12X 


16X 


y 

aox 


Pages  de  couleur 

Pages  damaged/ 
Pages  endommagies 

Pages  restored  and/or  laminated/ 
Pages  restaurdes  et/ou  pelliculdes 

Pages  discoloured,  stained  or  foxed/ 
Pages  ddcolordes,  tachetdes  ou  piqudes 

Pages  detached/ 
Pages  ddtachdes 

Showthrough/ 
Transparence 

Quality  of  print  varies/ 
Quality  indgale  de  I'impression 

Includes  supplementary  material/ 
Comprend  du  matdriel  suppl^mentaire 


P< 
of 
fil 


Oi 
b( 
th 
sii 
ot 
fil 

Si( 

or 


I      I    Only  edition  available/ 


Seule  Edition  disponible 

Pages  wholly  or  partially  obscured  by  errata 
slips,  tissues.,  etc.,  have  been  refilmed  to 
ensure  the  best  possible  image/ 
Les  pages  totalement  ou  partieilement 
obscurcies  par  un  feuillet  d'errata,  une  pelure, 
etc.,  ont  6td  fiim^es  d  nouveau  de  fapon  d 
obtenir  la  meilleure  image  possible. 


Tl 
sh 
Tl 
w 

M 
di 
er 
be 

"t 
re 
m 


26X 


30X 


24X 


?9X 


n 

32X 


Ills 

difier 

ine 

lage 


ata 


Blure, 


J 


t2X 


The  copy  filmed  here  has  been  reproduced  thanks 
to  the  generosity  off: 

National  Library  of  Canada 


The  images  appearing  here  are  the  best  quality 
possible  considering  the  condition  and  legibility 
off  the  original  copy  and  in  keeping  with  the 
filming  contract  specifications. 


Originfai  copies  in  printed  paper  covers  are  filmed 
beginning  with  the  ffront  cover  and  ending  on 
the  last  page  with  a  printed  or  illustrated  impres- 
sion, or  the  back  cover  when  appropriate.  All 
other  original  copies  are  filmed  beginning  on  the 
first  page  with  a  printed  or  illustrated  impres- 
sion, and  ending  on  the  last  page  with  a  printed 
or  illustrated  impression. 


The  last  recorded  frame  on  each  microffiche 
shall  contain  the  symbol  -^  (meaning  "CON- 
TINUED"), or  the  symbol  V  (meaning  "END"), 
whichever  applies. 

Maps,  plates,  charts,  etc.,  may  be  ffilmed  at 
different  reduction  ratios.  Those  too  large  to  be 
entirely  included  in  one  exposure  are  filmed 
beginning  in  the  upper  left  hand  corner,  lefft  to 
right  and  top  to  bottom,  as  many  frames  as 
required.  The  ffollowing  diagrams  illustrate  the 
method: 


1 
1 

2 

3 

L'exemplaire  ffiimd  ffut  reproduit  grdce  d  la 
g6n6rosit4  de: 

Bibliothdque  nationale  du  Canada 


Les  images  suivantes  ont  6t6  reproduites  avec  le 
plus  grand  soin,  compte  tenu  de  la  condition  et 
de  la  netteti  de  I'exempialre  fiim^,  et  en 
conformity  avec  les  conditions  du  contrat  de 
ffilmage. 

Les  exemplaires  originaux  dont  la  couverture  en 
papier  est  imprim^e  sont  ffilmds  en  commenpant 
par  le  premier  plat  et  en  terminant  soit  par  la 
dernidre  page  qui  comporte  une  empreinte 
d'impression  ou  d'illustratlon,  soit  par  le  second 
plat,  selon  le  cas.  Tous  les  autres  exemplaires 
originaux  sont  ffiimds  en  commengant  par  la 
premiere  page  qui  comporte  une  empreinte 
d'impression  ou  d'illustration  et  en  terminant  par 
la  dernidre  page  qui  comporte  une  telle 
empreinte. 

Un  des  symboles  suivants  apparaltra  sur  la 
dernidre  image  de  cheque  microfiche,  selon  le 
cas:  le  symbole  — ►  signifie  "A  SUIVRE",  le 
symbols  V  signifie  "FIN". 

Les  cartes,  planches,  tableaux,  etc.,  peuvent  dtre 
filmte  d  des  taux  de  reduction  diffdrents. 
Lorsque  le  document  est  trop  grand  pour  dtre 
reproduit  en  un  seul  clich6,  il  est  ffilmd  d  partir 
de  I'angle  supdrieur  gauche,  de  gauche  d  droite, 
et  de  haut  en  bas,  en  prenant  le  nombre 
d'images  ndcessaire.  Les  diagrammes  sulv&nts 
illustrent  la  m6thode. 


1 

2 

3 

4 

5 

6 

MEDICAL 


)t\ 


SKETCHES 


OF   THE 


I 


CAMPAIGNS  OP  1813,  13,  14. 

TO   WHICH    ARE    ADDED, 

SURGICAL  CASES;  OBSERVATIONS  ON  MILITARY  HOSPITALS;  AND  FLYING 
HOSPITALS  ATTACHED  TO  A  MOVING  ARMY. 

ALSO, 

AN  APPENDIX, 

COMPRISING 

A    DISSERTATION    ON    DYSENTERY; 

WHICH  OBTAINED  THE  BOYLSTONIAN  PRIZE  MEDAL  FOR  THE  YEAR  180« 

AND 

OBSERVATIONS  ON  THE  WINTER  BPIDEMIC  OF  1815-16, 

'  DENOMINATED 

PERIPNEUMONIA  NOTHA; 


AS  IT  APPEARED  AT  SHARON  AND  ROCHESTER, 
State  of  Massachusetts. 


i:  .  ■'<  iy\ 


BY  JAMES  MATil^.  M.  D.  A.  A.  S. 

Hospital  Surgeon  of  the  Army,  Member  of  the  Massachusetts  Medical  Sockty«  and 
Corrt'Sjioudiiig  Member  of  the  Georgiua  Medical  Society. 


^A. 


;'i 


dedham:  -'^ 

PRINTED  BY  H.  MANN  AND  CO,      ' 
1816.  •'    ^ 


■-.w,- 


district  of  Massachusetts^  to  wit: 

Dutrict  CItrk'f  Offlrr, 
BE  IT  HEMEMBERED,  tlint  on  the  Twinty-sixth  day  of  August,  mid  in  ilit  Korty-fiiit 
Vonr  oi'tlif  Iniliptnilijiiue  of  tbe  United  Slattg  u^Amtriea,  JAMES  MANNof  tlic  «aid  District, 
has  (U'lMsiutl  in  tlii!>  Office  the'  Title  of  a  Book,  the  right  whereof  he  claims  as  Author,  iu  tlm 
AV'oiils  fulloniii);,  to  ivit : 

"  Meilical  Sketches  of  the  Camp«inis  of  1812, 13, 14.  To  whidi  arc  a(!ded.  Surreal  caseqi 
"  OhservHtions  on  Militar)-  IIosi>iials ;  ami  Flying  Hospitals  attai'lud  tu  a  movini;  Army. 
"  Also,  iui  Api)eiidix,coni|)ri!iing  a  Uiswilution  on  liysinti  ry;  which  obtainid  the  Boylstoidan 
"  Pri/.f  Medal  for  the  year  1806.  Ami  ubs.  rviitions  on  tht  Winttr  Epidiniic  of  1815,  16.  di> 
"nominated  Piripnt'iimonia  Motlui ;  as  it  appiiind  at  Sharon  and  Ruihestcr,  Sl^te  of  Mussa- 
"ihusetts.  By  JAMKS  MANN,  M.  D.  A.  A.  S.  Hospital  Surgion  of  tlie  Amiy,  M.  niber 
"  of  the  Ma«sa'vliUK'tt(  Medical  Society,  and  Corrtspouding  Memwr  of  the  Georgian  Sledicd 
*'  Society." 

tn  Conformity  to  the  Act  of  the  Cong^'ss  of  the  United  States,  entitled,  "  An  Act  for  the 
£ncoiinig(.'ment  oi'Ltarninf;,  by  ateuring  the  Copies  of  Maps,  Charts  aiHl  Books,  to  the  Autliori 
and  Proprietors  of  such  Copii  s,  during  the  Times  therein  nic ntiontd :"  and  also  to  an  Act  eiw 
titlul, "  An  Act  suppK-nientHry  to  an  Act,  entitli  d.  An  Act  for  the  Encouragi  m.  nt  of  L<  anunr, 
by  securing  th»  Copies  of  Mjijts,  Chnrls  luid  Books,  to  the  Authors  and  Proprirtors  of  such 
Copits  durint;  ihi  tinns  thireia  memiomti;  ami  extending  the  Benefits  thi  reoi  to  the  Art:  of 
Uenguing,  £»rrA>his  and  EtcfaibK  Hiawricoi,  anl  utbtcr  rrints." 

Ckrl-  ■^rthe  Uistrict 
:  :^  of  <ttamt'''usettt.- 


ADVERTISEMENT^, 


if 


In  con«e«[ueijce  of  an  order  from  Major  General  Brown,  Conf: 
■lander  in  Chief  of  the  second  division  of  the  army,  to  re<>;iir 
io  Detroit,  these  sheets  were  hurried  through  the  press,  buiue 
typographical  errors  have  consequently  escaped  notice;  the 
most  essential  will  appear  subjoined  under  Errata.  No  apolo- 
gy will  be  made  for  the  work  in  general ;  that  something  of  the 
kind  may  be  better  executeil,  is  desirable.  The  communica- 
tions from  Doctors  Hunt,  Lovell,  Fuller,  Whitridge,  Pur- 
cell  and  March,  need  nothing  to  recommend  them ;  as  upon 
perusal,  they  will  be  found  interesting  to  the  physician,  and 
•reditable  to  the  authors. 

To  Horatio  Gates  Stafford,  Esq.  my  acknowledgment? 
Are  particularly  due.  The  statistical  observations  comprised  in 
the  book,  are  abstracts  from  a  Gazetteer  of  the  State  of  New- 
York,  written  by  him,  and  published  by  South  wick,  in  1813; 
as  Well  as  a  few  historical  facts,  relative  to  the  first  settlements ; 
^'hich  were  more  especially  introduced,  to  give  distant  readersr 
some  idea,  whnt  dangers  and  difficulties  the  first  settlers  had  to 
encounter;  and  the  astonishing  rapid  increase  of  the  North- 
western district  of  New-York.  Upon  the  last  subjects,  much 
might  have  been  added,  but  they  are  more  appropriate  to  a  ge- 
ographical work.  For  a  particular  description  of  the  state  of 
Kew-York  at  large,  and  especially  the  new  settlements  in  the 
Korthern  and  Western  counties,  less  generally  known,  the  read- 
er is  referred  to  that  circumstantial  and  comprehensive  Gazett- 
eer, which,  by  competent  juilges,  is  considered  most  correct. 


f 


iv 


ADVERTISRMENT. 


The  note  on  tlie  >vinter  epiilemic,  at  Sharon  and  Rochester. 
in  Ihe  State  of  Massacliiisetts,  was  not  contemplated  ia  the  lirst 
prospectus  of  the  book  ;  the  transantiuns  at  tliose  places  having 
occurred  since  it  was  published  ;  but  will  be  no  less  interesting 
to  medical  readers,  especially  in  those  parts  of  New-England, 
where  the  epidemic  made  dreadful  ravages.  The  stimulating 
practice  in  that  disease,  had  previously,  on  the  frontiers,  been  op- 
posed with  some  warmth.  In  the  last  instance,  it  has  not  been 
treated  with  too  much  severity  ;  although  this  absurd,  destruct- 
ive practice,  in  many  instances,  had  been  adojtted  by  gentlemen 
of  high  standing  as  physicians  ;  whose  medical  knowledge  1  res- 
pect, and  friendship  highly  esteem. 


ERRATA. 


i*age  14— 2d  line  from  top,  {or  forinacca,  rehd  farinacca. 
34_10th  line  from  bottom,  {or facal  resid  fecal. 
3* — 18th  line  from  bottom,  for  cnchriale  read  inchriale. 
54 — 15th  line  from  top,  for  various  read  iimncroits. 
5!) — 8tli  line  from  top,  for  jvait  read  wailed. 
70— 16th  line  from  bottom,  for  ipcracuanhnft  nrrr  read 
ipecacuanha  was. 


TO  MAJOR  GENERAL  DEARBORN. 


t1 


Sir — The  tried  patriot,  who  dared  to  resist  the  oppressive 
measures  of  a  despotic  government,  demands  our  reverence.  At 
an  early  period  of  life,  when  your  country  required  the  aid  of 
all  its  citizens  to  secure  its  independence,  you  relinquished  your 
medical  pursuits,  and  abandoned  every  domestic  enjoyment,  for 
tlie  perilous  and  uncertain  events  of  war.  You  have  heheld  the 
sceptre  of  a  king  broken,  and  his  crown  trodden  under  foot. 
You  have  seen  a  despotic  power  crouch  to  rational  liberty,  and 
the  ])rinciples  of  the  inalienable  rights  of  man,  emerging  from 
that  thraldom,  which  a  blind  fuith  in  hereditary  power  im|)osed 
on  the  mind.  The  American  revolution,  in  which  you  bore  a 
cons|)icuou3  part,  was  not  merely  a  victory  of  arms,  but  a  glo- 
rious triumph  of  lurinciple.  .■^" 

The  warm  advocates  of  a  democratic  form  of  government, 
have  not  been  disappointed ;  they  have  rejoiced  in  the  unex- 
ampled prosperity  of  the  nation,  under  a  novel  regimen,  while 
more  than  thirty  years  of  successful  experiment  have  demonstra- 
ted, that  a  rejiresentative  government,  is  adequate  to  meet  every 
exigency  of  the  nation,  and  under  the  most  threatening  dangers, 
to  call  forth  her  resources  to  oppose  them. 


•^' 


m 


^}  90  MAJOR  OFNKRATi   nBARBORI^. 

Aflor  a  lone  jieriod  of  prosperous  peace,  war  was  again  pro. 
voke«'..     To  avenge  the  insults  and  aggressions  of  an  imperious 
and  haughty  enemy,  arms  were  resorted  to.     Fiora  what  class 
of  citizens  was  it  to  have  heen  expecteti,  the  government  woulil 
select  a  leader  for  its  army  ?  But  from  the  few  existing  veterans, 
\Yho«e  military  talents  and  prowess,  had  been  already  proved  on 
Ihe  tented  field,  and  in  the  day  of  battle.     A  few  only  of  that 
long  catalogue  of  heroes,  -.vhose  memories  will  always  be  cn« 
gnven  on  the  hearts  of  the  nation,  still  lived.     Prom  this  rem- 
nant, you,  Sir,  was  selected,  and  promoted  to  the  high  grade  of 
M.vjoH  GBNF.RAii  in  the  army.     It  belongs  to  those  who  have 
witnessed  the  |)erplexities  and  embarrassments  attending  the 
orsinnization  of  an  undisciplined  body  of  men,  to  appreciate  your 
mrrits.     Tills  rude  assemblage  of  troops  under  your  command, 
learnt  the  tirst  rudiments  of  war,  and   were  taught  to  beat  the 
most  celebrated  veterans  of  Euro|)e.     You  was  a  witness  of 
the  effects  of  eight  months'  discipline.     Your  early  and  rapid 
movements  in  1813,  preserved   Sa«kett'fl   Harbor  and  the  fleet 
on  liake  Ontario.     The  plans  of  attack  prescribed  by  yourself, 
on  Little  York  and  Fort  George,  bear  testimony  to  your  mili- 
tary talents ;  and  how  much,  under  able  Generals,  the  American 
soMiery  were  capable  of  accomplishing.      The  very  brilliant 
victory  of  their  arms,  soon  compelled  the  enemy  to  sue  for  peace. 
At  the  termination  of  a  war,   honorable  to  the  nation,  you  rcr 
tired  to  domestic  enjoyment,  accompanied  with  the  benedictiona 
of  the  army,  and  full  approbation  of  your  country  ;  and  with  the 
pleasing  consolation,  that  no  officer  has  presumed  to  exhibit  pub- 
licly,  an  allegation  against  you,  nor  by  private  insinuations,  at-. 
temj)ted  to  detract  from  your  well  deserved  (ixmph 


TO    MAJOR   CIENP.RAL   DGARBORtC  -ylj 

*  if  at  liny  perlo<I,  the  wily  serpent  of  envy,  or  nn  enemy  of 
government,  remote  from  tlie  scenes  of  your  active  services,  has 
presumed  to  erect  its  head,  to  l)last  with  its  venomous  poison 
your  unsullied  reputation;  it  soon  retired  from  the  refulgent 
beams  of  truth,  appalled,  to  its  native  dark  cell,  there  to  expend 
its  malignancy,  while  it  secretly  broods  over  its  own  disa|N 
pointment. 

The  brave  and  virtuous  call  forth  our  esteem  and  awaken  our 
affec!ioii9.  Honors  are  not  the  exclusive  inheritance  of  any  or- 
der of  men.  Integrity  is  found  in  the  private  walks  of  life.  The 
high  offices  of  government  acccssable  to  all,  are  beheld  us  pub' 
lie  stations,  in  which  the  citizens  in  succession,  perform  their 
tours  of  duty.  Those  who  have  executed  their  task  with  in- 
tegrity, claim  our  first  respects,  and  possess  our  unfeigned  re- 
gards. Many  of  these  most  important  trusts  have  been  commit- 
ted to  your  charge,  in  which  your  faithfulness  has  been  tried 
and  proved. 

In  your  retirement,  you  have  an  opportunity  to  take  a  retra- 
spective  view  of  the  various  scenes  you  have  passed,  possessing 
the  conscious  satisfaction,  it  has  been  your  peculiar  good  fortune 
to  have  performed  your  routine  of  duty,  to  the  general  accept- 
ance of  the  nation. 

It  still  remains  for  me  to  express  my  own  acknowledgments  for 
your  assistance,  while  I  had  the  honor  to  perform  duty  under 
your  command.  Your  knowledge  of  medical  science,  enabled 
you  duly  to  estimate  the  importance  of  the  hospital  department 
«fthe  army.  In  the  orgnnization  of  which,  no  small  benefits 
were  derived  from  your  advice  and  juUiciuus  counsels. 


Vlii  TO   MAJOR    ffrN».nAL    DKARBOnV. 

May  you  long  \\\f  (<>  rnjoy  llir  aiiiin-mt'  Butiafaction  resulting 
from  the  rctroapeclion  of  n  lite  devoted  to  your  country,  well 
spent  in  her  aervice;  while  it  is  with  peculiar  pleftsiire,  these 
«li«'el8,  expressive  of  my  hi'^h  respects,  ami  wishes  for  the  con- 
tinuance of  your  happiness  in  this,  as  well  ns  that  life  which  is 
anticipated  by  all  christians,  an-  to  you  inarribcd  by 
your  moat  ouedienl  servant, 

JAMES  MANN. 


1*RELIMINAIIY  OBSERVATIONS. 


vwvww^vvv 


TO  trnce  the  vnrioiiB  cnusea,  which  Involved  the  United 
States  in  the  lute  war  with  Great  Britain,  is  the  province  of  the 
political  histurian.  It  has  Ix'en  u  question,  whether  It  was  ^ood 
policy,  to  o|)|>08e  ,vith  menacing  altitude,  the  atriiresaions  of  uii 
enemy  previous  to  maturing  warlike  preparations  for  defence. 
There  are  periods  when  the  most  important  concerns  of  u  na- 
tion, under  all  governments,  will  be  controled  l>y  puhlic  opinion. 
Such  was  the  state  of  alfairs,  at  that  evei  memorable  epocha, 
when  the  war,  which  terminated  in  the  independence  of  the 
United  States,  was  commenced.  Under  a  republican  govern- 
ment, the  voice  of  the  (teople  will  dictate  the  measures  to  be 
pursued.  Provocations,  similar  in  their  consequences  to  those, 
which  excited  the  revolutionary  war,  existed  in  1812.  A  state 
ef  war  was  demanded  by  tlie  nation,  at  a  period,  when  no  prep- 
arations for  even  defensive  operations  had  been  made ;  whea 
military  equipments  were  to  be  furnished,  and  an  army  to  be  re- 
cruited. To  systemHfize  llie  various  deparlments  of  which,  was 
an  employment  which  required  months  to  accomi)li3h.  That 
military  character,  which  had  liecn  acquired  by  the  nation,  dur- 
ing a  war  of  seven  years  to  establish  its  independence,  was  lost. 
An  uninterrupted  peace  of  thirty  yeais  had  obliterated  almost 
every  vestige  of  military  knowledge.  The  art  of  war  slumbered 
with  the  heroes  of  the  revolution.  Martial  renown  was  unknown, 
except  on  the  pages  of  the  impartial  and  faithful  historian ;  while 
the  records  of  military  deeds  and  glory,  in  the  United  States, 
like  fancied  tales,  excited  wonder  and  p'easure,  rather  than  eli- 
cited that  patriotic  fire,  which  warms  the  breast  f  T  ^he  soldier, 
and  glows  in  the  soul  of  the  hero,destined  to  protect  the  r  <• 
and  avenge  the  wrongs  done  his  country. 

Habits  of  subordination  cannot  be  immediately  acquired  by 
«xen  taken  into  the  field  from  domestic  employment.    Recruits^ 


i1 


1 


m^m 


Vi 


m 


rBELIUIMA&T  OBBERVATIONB. 


asBemhled  froAi  dictricta  remote  Trom  each  other,  possessing  lo- 
«al  prejudices,  and  dissimilar  manners,  could  not  in  a  moment  be 
Tvell  disciplined.  To  orgaiiize  an  army,  composed  of  such  heter- 
ogeneous materials,  with  oflficers,  who  had  yet  to  learn  the  duties 
of  the  camp  and  tield,  was  a  laborious  task.  It  was  an  employ- 
ment, which  called  into  requisition  much  patience  and  persever- 
ance. In  the  execution  of  these  duties,  through  the  campaign, 
profound  wisdom  and  judicious  management  were  displayed  bj 
the  Commanding  General. 

The  medical,  with  other  departments  of  the  army,  at  the  com- 
mencement of  the  war,  wanted  a  system.  Military  hospitals 
were  to  be  founded  by  gentlemen,  little  versed  in  hospital  estab- 
lishments, for  an  army.  These  were  evils,  the  necessary  con- 
sequence of  our  civil  polity,  and  long  period  of  peace ;  and 
which,  all  new  military  establishments  have  to  encounter. 

The  acceptance  of  an  appointment  of  hospital  surgeon  in  the 
army,  placed  me  in  a  novel  situation.  An  order  from  Major 
General  Dearborn  was  received,  to  repair  to  Greenbush,  State 
of  New- York,  the  place  assigned  for  the  general  rendezvous,  and 
superintend  the  medical  department  of  the  northern  army.  The 
mere  orgn  nidation  of  hospitals  wak  the  least  perplexing  part  of 
duty.  The  illy  defined  powers,  with  which  the  hospital  sur- 
geons were  invested,  even  in  their  own  department,  subjected 
them  to  many  disagreeable  interferences  of  the  officers  of  the 
line.  Collisions  will  always  exist,  between  officers  of  different 
departments  of  an  army ;  when  their  several  powers  and  duties 
are  not  explicitly  pointed  out.  Officers,  tenacious  of  authority, 
assume  as  much  as  may  be  implied  by  rules  and  regulations. 

In  addition  to  multi[)lied  embarrassments,  the  various  duties 
attached  to  the  office  of  hospital  surgeon,  with  those  merely  pro- 
fessional, was  always  so  pressing,  that  little  time  was  allowed 
to  record,  particularly,  the  diseases  and  medical  transactions  of 
the  army,  as  they  occurred.  It  is  a  matter  of  regret,  that  many 
interesting  cases  have  bee^v  lost,  which  might  have  rendered  the 
following  sketches  more  comprehensive,  perhaps  useful;  for 
want  of  which,  only  a  general  view  of  the  diseases,  which  pre- 
vailed during  the  war  will  be  given,  with  such  treatments  «( 
COine  under  my  observation. 


PRBLIMINART   OBSERVATTONlt. 


VU 


An  extensive  field  Tor  investigating  the  causes  of  diseases  in« 
cident  to  armies,  tlieir  prevention  and  cure,  was  open  during  th« 
revolutionary  contest,  but  was  not  improved  Tor  our  benefit. 
The  physicians  and  surgeons  of  that  eventful  period  neglected 
to  transmit  to  us  their  experience  and  observations.  Excepting 
a  few  remarks  interspersed  in  works  of  Dr.  Rush,  all  to  us  is  lost. 
At  the  commencement  of  that  war,  the  mortality  which  prevail- 
ed among  the  troops  was  greater  than  the  Inst.  The  forms  of 
diseases,  in  all  probability,  were  similar.  The  medical  staff  of 
the  army  of  1812,  possessing  no  documents  relative  to  the  man- 
agement of  military  hospitals,  nor  the  diseases  to  which  our  ar- 
mies were  exposed,  to  direct  them  to  the  most  suitable  means  of 
obviating,  or  the  most  successful  methods  of  treating  them» 
which  in  many  instances,  assumed  forms  different  from  those 
which  occur  in  domestic  practice,  necessarily  had  recourse  to 
European  treatises  on  military  hospitals  and  diseases  of  th9 
camp.  The  practice,  on  the  eastern  continent,  in  diseases  ap- 
parently similar,  is,  in  many  instances,  illy  adapted  to  the  cure 
of  the  diseases  peculiar  to  the  United  States.  We  are  led  fur- 
ther to  observe,  that  while  we  consult  practical  authors,  some 
regard  should  be  had  to  climates  and  local  situations,  where  their 
observations  were  made.  Hence,  a  knowledge  of  geography  in 
general,  and  topography,  are  particularly  important  to  the  phy- 
sician and  surgeon,  to  become  acquainted  with  the  connection 
which  subsists  between  climates  and  constitutions,  in  exploring 
the  manner  diseases  are  affected  thereby,  inasmuch  as  looal  sit- 
uations and  climates  produce  varieties  in  the  human  constitu- 
tion, which  diversify  the  forms  of  disease.  -  "■' 

The  medical  philosopher  is  not  ignorant  that  the  diseases  of 
different  climates  assume  forms  which  are  peculiar  to  their  local 
position ;  that  the  treatment  of  the  diseases  of  one  climate,  is  not 
always  applicable  to  ihose  of  a  different ;  also,  the  diseases  of  the 
same  climate  in  different  years,  and  during  the  varying  seasons 
of  the  vear,  are  not  always  to  be  treated  in  a  similar  manner. 

The  last  observations  are  particularly  applicable  to  tlie  Unit- 
ed States,  whose  extensive  territories  and  districts  embrace 
within  their  linits,  a  vast  variety  of  climates ;  interspersed  with 


I' 


" 


'H 


in 


^i^: 


It, 
1 


}     I 


IW« 


viii 


FRKLtMlNAEV    OBHFRVATI0N8. 


large  improved  tracts,  vast  rimstB  in  tlie  wildest  comliiion,  ami 
extensive  ten  i lories  in  iutermediHte  states,  from  nature  in  her 
rutlcst  attire,  to  the  highest  grades  ofcultivution. 

Sydenham,  an  accurate  observer  of  tlie  nature  of  diseases, 
>vhile  noticing  the  changes  produced  in  their  forms  Uy  transi* 
tions  of  seasons  and  weather,  observed  that  the  fevers  of  his 
time,  year  succeeding  year,  required  dilTerent  methoils  of  prac- 
tice. He,  likewise,  cured  dysentery  at  one  period,  by  cathar- 
tics, at  another  by  opium.  Our  own  practice  confirms  the  just- 
ness ofthealwve  observations.  Intermittent  fever  amoiij;  the 
•oldiers  we  siiali  select  as  one  disease;  which  at  Grc  bush  in 
1812,  at  Lewislovvn  on  the  Niagara  in  1813,  at  Burlington  in 
1814,  required  different  methods  of  treatment.  > 

Experience  has  taught  us,  the  health  of  men  is  more  or  less 
affected  by  change  of  climate.  Soldiers,  ordered  on  service  to  a 
district  whose  temperature  differs  from  that  to  wliich  they  had, 
from  early  life,  been  habituated,  are  more  sulyect  to  its  endemic 
diseases,  and  have  severer  attacks  from  them,  than  the  natives. 
The  winter  epidemics  on  the  northern  frontiers,  it  was  remark- 
ed, were  more  mortal  among  the  troops  from  South  of  Delaware 
river,  than  those  from  the  New-England  states.  This  fact  was 
most  evident,  during  the  winter  epidemic  1813-14,  in  the  lOth 
Regiment,  at  Plattsburgh.  In  the  distribution  of  troops,  it  is 
important  that  regard  be  had  to  their  habits,  and  the  climates  to 
which  they  may  be  ordered  for  duty.  "  Diseases  are  so  modi- 
fied and  varied  by  different  situations  and  local  posil?ons,  habits 
of  life,  constitution,  age  and  temperament,  as  well  as  transitions 
of  climate  and  weather,  their  various  forms  are  almost  infinite."  , 

An  epidemic,  which  takes  its  general  features  from  a  pesti- 
lential state  of  atmosphere,  when  it  invades  a  vast  extent  of 
country,  assumes  a  variety  of  forms ;  whence  originate  among 
physicians  seisms,  varient  opinions,  and  opposite,  as  well  as  in- 
decisive methods  of  practice.  When  these  disagreements  exist 
in  the  same  district,  incalculable  evils  are  often  the  conse- 
quence. But  80  far  as  they  are  applicable  to  the  several  dis- 
tricts, where  they  exist,  the  apparent  difference  of  treating  the 
disease  may  be  correct.     The  winter  epidemic  of  1812-13,  was 


PRELIMIKAKT   OBSERTATI0N», 


IK. 


ample  proof  of  the  above  remark.     On  the  northern  frontiers,  it 
assumed  forms  highly  inflammatory,  accompanied  not  only  with 
strong  arterial  action,  but  higher  degrees  of  stenic   Kathcsis,  in 
which  the  lungs  were  so  gorged  with  blood,  that  the  heart  and 
arteries  almost  ceased  to  act,  inducing  at  the  extremities  and  on 
the  surface  of  the  body,  torpidity  and  coldness  ;  symptoms,  bear- 
ing the  semblance  of  a  typhoid  state  of  disease.     In  the  vicinity 
of  New- York  city,  the  disense  supervened   with  symptoms  less 
inflammatory.     At  Washington  city,  the  disease  exbihi..     few 
or  little  symptoms  of  inflammation,  and  was  considered  a  form  of 
typhus  fever.       This    epidemic   most   generally  obtiiinrd   the 
game  nosological  appellation ;  but  in  different  districts  of  the 
country  was  qualified  by  some  specific  name,  which  was  suppos< 
ed  to  be  applicable  to  its  existent  form.     In  addition  to  its  gen- 
eric  denomination,  pneumonia ;  it  was  called  at  one  place,  p^teu- 
monia  notha ;  at  another,  pneumonia  typhoides ;  malignant  pleti- 
risy  at  a  third;  and  at  a  fourth,  bilious  pneumonia.     It  was  also 
denominated  a  highly  malignant  bilious  fever,  from  a  persua- 
sion  that  the  organs,  subservient  to  the  secretion  of  the  bile,  or 
a  redundance  of  that  fluid,  wa^   a   cause  of  the   derangement. 
These  varient  opinions  may  be  seen  in  communications  upon 
the  epidemic  1812,  13,  I'l,  published  in  the  Medical  Reposi- 
tory, New-York. 

This  epidemic,  when  it  firet  appeared  on  the  northern  fron- 
tiers, was  accompanied  with  symptoms  so  uncommon,  that  some 
physicians  were  induced  to  consider  it  a  new  or  anomalous  dis- 
ease. It  was  not  correctly  understood  by  the  surgeons  of  the 
army,  until  its  nature  was  ascertained  by  dissections  of  those 
who  were  its  victims.  After  the  morbid  states  of  the  viscera 
were  demonstrated,  the  physicians  adopted  a  practice  more  suc- 
cessful ;  while  these  examinations  were  proofs  convincing,  that 
this  mortal  disease  had,  heretofore,  been  known  in  Europe ;  a 
most  accurate  description  of  which,  John  Bkll  has  given  in  his 
anatomy  of  the  human  body,  which  may  be  found  in  his  1st  vol. 

New- York  edition,  page  136.     ■    ■■  "  

A  correct  history  of  an  extensive  epidemic  cannot  be  obtain- 
ed, except  from  collected  statements  from  the  various  sections 


.«i! 


fc 


I 


PRELIMINARY   OaSRRVATIONB. 


of  a  country  ^here  it  lias  prevailed.  How  important  then,  that 
the  forms  of  disease,  with  their  treatment,  be  reported  iu  every 
territory,  that  they,  severally,  may  he  furnished  with  a  method 
of  practice  best  adapted  to  its  climate  or  local  position  !  Such 
medical  documents  may  be  highly  useful,  so  far  as  they  may  be 
particularly  applicable  to  the  various  climates  of  an  extensive 
eountry. 

The  surgeons,  attached  to  the  army,  ihe  last  war,  would  be 
well  employed  to  impi-ove  the  present  time  to  commence  a  his- 
tory of  the  diseases  attendant  on  a  military  life.  A  fund  of  use- 
ful ( 'jservations  might  with  little  industry  be  collected,  and  pre- 
served for  the  benefit  of  future  generations.  Its  value  would  be 
enhanced  proportionate  to  the  additions  which  may  be  made  to 
the  general  stock ;  in  which  every  surgeon  of  Ihe  army  should 
feel  he  has  an  interest. 

The  Sketches  are  a  partial  exhibition  of  the  diseases  on  the 
northern  frontiers,  to  which  district  the  author  was  attached  dur- 
ing the  war;  being  abstracts  of  medical  observations  made  at 
those  points  only,  where  he  was  a  witness  of  them,  ^Yitll  reports 
from  a  few  gentlemen  of  the  medical  department,  w  lo  were  con- 
versant with  the  diseases  as  they  appeared  in  camp  a  '  the  mil- 
itary hospitals ;  to  whom  particular  acknowledgments  will  be 
made,  in  due  place,  for  their  aid  and  matter  furnished  for  this 
compilation.  ■■'>  •  ■ ; 

.Although  the  sketches  may  be  considered  as  comprising  a 
small  portion  compared  with  the  great  body  of  facts  which  may 
be  adduced ;  yet,  however  small,  they  may  prove  of  some  bene- 
fit to  medical  science.  A  record  of  incorrect  practice,  faithfully 
detailed,  may  be  improved,  like  a  beacon  to  a  mariner,  to  avoid 
dangers  and  erroneous  tracks. 

These  sketches  may  be  further  useful  to  the  science  of  medi- 
cine, to  excite  others,  who  were  attached  to  the  medical  de- 
partment of  the  army,  possessing  matter  of  greater  importance, 
and  more  leisure  and  talents,  to  appropriate  them  to  this  highly 
important  subject — the  preservation  from  disease  and  death,  of 
that  valuable  and  most  necessary  class  of  citizens,  who  are  em- 
ployed to  protect  the  rishta  of  the  nation,  and  support  its  inde- 
pendence. 


MEDICAL  SKETCHES. 


^^<V»»«^i%^)»***^»o 


CAMPAIGN  OF  181^. 


SOME  preliminary  remarks  upon  the  state  of  weather  prior, 
and  at  the  time  the  army  was  forming  at  Greenbush,  will  be 
made ;  also,  a  concise  topographical  description  of  the  canton- 
ment at  this  post  will  be  given,  by  which  an  opinion  may  be 
formed,  to  what  extent  the  diseases,  to  which  the  troops  were 
subjected,  may  have  been  protluced  by  local  causes,  or  their 
health  affected  by  atmospheric  influences,  which  depended  mere- 
ly on  local  situation. 

The  vernal  months  of  the  year  1812  were  unusually  wef, 
with  few  warm  days.  July  was  dry  and  hot,  succeeded  by 
floods  of  rain  in  the  month  of  August ;  when  the  weather  was 
■ncommonly  cool  for  the  season.  The  month  of  September 
was  pleasant  to  men  in  tents.  October  was  wet  and  cold.  The 
men,  during  this  month,  suffered  in  their  healths,  by  sudden 
transitions  of  weather.  Vegetation  was  later  this  spring,  by 
two  or  three  weeks,  than  usual.  Indian  corn  was  not  planted, 
in  the  eastern  states,  until  the  last  week  in  May,  and  the  first 
weeks  in  June.  Other  grains  were  put  into  the  ground  later 
this  season  than  was  usual ;  nevertheless,  the  productions  of 
the  earth,  although  retarded  by  cold,  were  generally  luxuriant. 
The  summer  grains  were  damaged  during  the  time  of  harvest  by 
rains.  Wheat  vegetated  in  the  fields  after  it  was  ripe.  Indian 
corn,  for  want  of  sufiRcient  heat,  did  not  generally  mature. 
This  was  noticed  throughout  th<'  aastorn  states,  and  the  north- 
em  district  of  New- York ;  the  crops  of  which  "3re  diminished 
one  half  by  the  early  frosts  in,  autumn. 


la 


MEDICAL  SKETCHES. 


: 


ii 


Rains  fell  in  such  abundance,  during  the  montli  of  August, 
that  the  earth,  even  on  declivities,  was  sort  and  miry.  This 
was  the  state  of  clay  grounds  at  Greenbush,  upon  which  the  ar- 
my encamped,  although  pn  elevated  plain.  To  remedy  the 
•vils  of  a  wet  encampme  a,  the  floorings  of  the  tents  were  rais- 
ed four  or  five  inches  above  the  surface  of  the  earth,  and  the 
encampment  frequently  changed  to  fresh  ground.  Many  of  the 
men,  at  this  time,  were  nevertheless,  attacked  with  dysentery 
and  diarrhoea.  Hospitals  were  not  prepared  to  receive  the  sick ; 
consequently,  they  were  attended  in  tents.  There  were  de- 
tachments of  several  regiments  in  August,  at  this  cantonment, 
amounting  to  about  1500  men.  From  the  first  week  in  Septem- 
ber, to  the  first  of  November,  regiments  and  detachments,  week 
after  week,  marched  to  and  from  this  post ;  during  which  time, 
the  number  of  men  varied  between  1500,  and  OOOO  :  while  sur- 
geons of  regiments  had  full  employment  in  their  duty ;  and  the 
tveekly  reports  of  the  general  hospital  counted  between  100  and 
130,  until  the  the  first  of  November;  at  which  time,  the  most 
of  the  troops  had  marched  to  the  frontiers :  when  about  200 
men,  unabite  to  accompany  their  regiments,  on  account  of  dis- 
eases and  infirmities,  remained  in  the  hospital. 

The  most  prominent  diseases,  among  the  troops  at  Greenbush, 
during  the  months  of  July,  August,  and  September,  were  disor- 
ders of  the  bowels,  under  the  forms  of  dysentery  and  diarrhoea. 
To  these  diseases,  recruits  when  they  take  the  field,  afe  gener- 
ally subjected ;  especially,  where  their  rations  for  diet  are  not 
prepared  in  the  most  suitable  manner.  These  diseases  may,  id 
some  measure,  be  obviated  by  obliging  the  men  to  cook  their 
food  in  the  form  of  soups.  This  regulation  should  be  ever  en- 
forced upon  men  in  the  field.  To  which,  they  will  cheerfully 
submit,  when  experience  has  taught  them  the  benefit  resulting 
therefrom.  The  science  of  preserving  health  is  too  little  known 
to  new  recruits ;  a  knowledge  of  which,  young  officers  unaccus- 
tomed to  the  police  of  a  camp,  do  not  impress  upon  them  the 
importance  of  acquiring.  An  inattention  to  a  proper  dietetic 
management  was  among  the  causes  of  diseases  and  mortality, 
lEcident  to  our  troops  ;  to  which  may  be  added,  filtbiaess,  and 


CAMPAIGf^  OP  1812. 


JO 


an  infempernte  use  of  i.rdent  sjiirils.  These  sources  of  diseaati 
we  9'i  ill  have  repealed  ocraaion  to  notice  ;  as  frequent  causea  of 
the  failure  of  im  lorfant  expeditions,  and  ruin  of  armies;  by 
Avhich,  the  highest  expectations  of  a  nation  are  often  disappoint' 
ed. 

Th«  dysentery  -or  this  campaien  was  not  ncrompanied  with 
Vncommon  symptoms.    A  detailed  d'sc.ription  of  which    is  unint" 
portant,  as  it  su{)er\ened  umtev  forms  most  generally  described 
by  medical  authors.     It  was  observed,  li.at  this   disease  at  its 
commencement  during  the  campaign,  was  attended  in  most  cases 
with  a  fever  of  the  synochal  type,  accelerated  action  of  the  ar* 
teries,  and  heat  increased  considerably  above  the  healthy  stand* 
ard.     With  these  symptoms,  blood-letting  was  advantageously 
employed.     One  bleeding  of  sixteen  ounces  was,  in  most  cases* 
necessary.     This  was  followed  by  a  full  cathartic  of  calomel 
and  jalap ;  which  mitigated  all  the  urgent  symptoms  of  the  dis- 
ease.    A  repetition  of  a  cathartic  was  sometimes  requisite.     An- 
odines  became  an  appropriate  medicine  after  the  intestines  were 
well  evacuated.     In  cases  more  obstinate,  emetics  of  tartrite  oC 
antimony,  or  ipecacuanha  were  indicated ;  or  an  emetico-cathar«» 
tic  composed  of  calomel  and  tartrite  of  antimony.     There  were 
cases,  when  calomel  and  opium,  in  small  doses,  at  intervals  ojf 
Ibur  or  six  hours,  were  found  beneficial. 
Dysentery  assumed  a  typhoid  form,  in  some  instances,  whea 
the  patient,  at  lih  first  appearance  was  destitute  of  medical  aid. 
Some  of  this  description  were  admitted  into  the  general  hospital, 
at  Greenbush;  having  been  attacked  with  the  disease,  during  a 
long  passage  from  Rliode-Island  to  Albany,  crowded  in  vess<>Is, 
exposed  during  the  heat  of  the  day,  and  fogs  of  the  night  oa 
deck,  to  avoid  the  suffocating  state  of  air  in  the  hold.     Some  ot 
whom,  when  received  into  the  hospital,  were  in  a  bad  condition. 
For  these  patients  were  prescribed  cathartics  of  sulphate  of  soda  ; 
BUper-tartrite  of  potash  and  manna;   many  of  whom  required 
stimulants,  diluted  brandy,  wine.     To  one  were  administered 
from  one  to  two  pints  of  wine  daily,  for  two  weeks ;  and  by  this 
stimulus  only  was  supported,  and  apparently  from  a  dying  state, 
vjM  eventually  restored  to  health.    In  all  cases  of  this  disease,* 

3 


1 


.*•' 


L 


ll  MEDICAL  SKETCHES, 

animal  nutriment,  even  in  the  form  of  sotipa,  was  prohibited. 
Preparationa  of  the  forin;"ea  and  milk  were  experienced  the 
moat  appropriate  regimen.  A  milk  <liet  was  the  most  euit^tble 
during  the  state  of  convalescence,  from  this  diseuie.  There 
were  cases  where  relapses  followed  the  employment  of  animal 
food,  where  the  patients  were  in<lulged,  before  the  stom  ich  and 
bowels  had  recovered  their  healthy  tone. 

An  opinion  prevailed  among  the  soldiers,  that  ardent  spirits 
ViM  a  sovereign  remedy  for  these  complaints  of  the  l)owel8. 
This  persuasion,  added  to  an  habitual  propensity  for  these  li- 
quors, induced  many  to  have  recourse  to  their  intemperate  use. 
It  was  not  unfrequent  to  find  a  patient,  on  the  first  visit,  highly 
excited,  even  to  the  point  of  intoxication,  by  these  inebriating 
draughts.  This  fact  may  account  for  the  more  frequent  neces- 
«ity  of  employing  the  lancet  among  soldiers,  tbaa  citizens ;  not 
only  in  this,  but  all  forms  of  disease,  i 

Diseases  of  the  bowels,  among  the  troops,  appeared  most  fre- 
quent under  the  form  of  diarrhoea.  In  which,  cathartics  were 
also  employed ;  calomel  and  rhubarb ;  sulphate  of  soda.  When 
the  disease  was  accompanied  with  nausea,  and  anorexia,  emet- 
ics of  ipecacuanha  likewise  were  administered. 

Intermittent  fevers  of  the  tertian  type,  were  sometimes  con- 
nected with  these  complaints  of  the  bowels.  This  form  of  dis- 
ease was  noticed  at  Greenbush  hospital,  only  among  therecrult» 
from  south  of  Hudson  river ;  who,  previous  to  leaving  their  first 
rendezvous,  to  join  the  army,  had  been  seized  with  the  disease,^ 
and  had  recovered ;  but  relapsed,  while  on  their  long  passage  up 
the  Hudson,  in  crowded  vessels  ;  where  the  sick  were  neces»ari- 
ly  confined  below  deck.  Their  condition  had  become  bad ;  the 
type  of  the  fever,  changing  from  an  intermittent,  to  a  continued 
form.  Some  of  these  men  died,  soon  after  admittance  into  the 
hospital.  ,  ii  . 

When  the  paroxisms  of  these  intermlttents  recurred,  at  regu- 
lar periods,  the  cold  stage  of  the  fever  was  anticipated  Isy  aa 
emetic ;  which  seldom  failed  to  interrupt  the  diseased  associa- 
tions, and  thus  counteracted  the  hot  stage.  After  ils  first  pas- 
sages were  evacuated  by  emetics,  and  cathartics,,  and  during  t]i0 


CAMPAIGN  OP  181  J.  U 

hitermisslons,  bark  and  w!ne  were  directed.  These  inteimiU 
teniB  did  not  prove  ohslinate.  They  were  rca'ViIy  subdued, 
when  the  above  naeans  were  judiciously  managed. 

The  change  of  weather  was  great  and  sudden  in  the  month  of 
October.  Frosts  commenced  earlier  than  usual  this  autumn. 
This  transition  introduced,  among  the  soldiers  in  tents,  addition* 
al  Torms  of  disease.  Among  these,  were  acute  and  chronic  rheu- 
matism. Those  who  were  subjected  to  their  attacks  were  over 
forty  years  of  age  {  who,  previous  to  their  enlistment,  had  beea 
broken  down  by  either  hardships  or  intemperance,  or  both  conir 
bined.  Of  (his  description  of  soldiers,  many  remnined  at  Green- 
bush  hospital,  at  the  time  their  regiments  received  orders  to 
march  to  the  frontiers ;  whose  services  in  the  army  here  termi- 
nated, and  whose  only  tours  of  duty  were  short  marches,  during 
the  most  pleas  int  season  of  the  year,  from  their  first  reudezvoui^ 
to  this  cantonment.     (See  note  a.) 

The  bad  policy  of  government  was  now  most  evident.  Th« 
experiment  demonstrated,  that  an  efficient  army  on  the  war  ea* 
tablishment,  could  not  he  niised  by  the  small  encouragement 
offere<l  the  soldiers.  The  army  whs  composed  of  that  descrip- 
tion of  men,  \<ho  were  hn!)ituiiliy  indolent,  or  who  could  find  no 
other  employment.  Few  of  these  classes  are  found  in  the  Unit- 
ed Stiites.  Idleness  is  not  a  characteristic  feature  of  their  iu- 
habitants ;  who,  with  adequate  corapeiisHtion,  will  always  prove 
the  most  firm  sup|)orters  of  the  nation's  rights ;  and  who  wilt 
never  be  made  the  instruments  of  ambition  to  subvert  its  gov- 
ernment, nor  countervail  its  salutary  laws.  A  young  healthy 
man  disdained  to  enrol  himself  in  the  army,  for  a  compensation 
less  than  he  could  obtain  for  his  services  in  domestic  employ- 
ment. The  industrious  yeomanry  of  the  country,  of  whom  our 
efficient  armies  must  be  com|)osed,  and  who  will  fight  its  ene- 
mies, calculate  upon  adequate  pay,  with  as  much  exactness,  as  a 
merchant  calculates  upon  the  profits  of  a  trading  voyage. 

Acute  rheumatism  required  the  use  of  the  lancet ;  the  chronic 
form  seldom  demanded  bleeding.  These  forms  of  disease  gen- 
erally yielded  to  calcnel,  opium,  blisters  and  warm  lodgings. 
The  tepid  bath  would  have  proved  a  pleasant  remedy.    Th^ 


i  > 


;  .  t. 


{!. 


4 


If 


MEDICAL  SKETCHED. 


unorgntiizcd  stale  or  the  liuupitnl,  at  this  |HTio«I,  did  not  admit  ul' 
it>  cm|>loynieiit.  After  recovery,  the  patients  were  not  secured 
from  the  diseuse.  Kxposurps  to  >vel  and  cold,  sulijected  them  to 
renewed  nttiicka.  The  fuMowing  prcscriptioni  under  ditTereut 
circutnstanceB  were  administered.     (See  note  b.)  ,,     , 

Measles  shewed  themselves  among  the  soldiers,  in  a  few  ia- 
stanct'S,  at  (jreenbush.  The  disease  was  mild,  and  generalljr 
little  or  no  mtdicul  aid  was  required.  Bleeding  in  two  or  three 
instances  was  necessary  ;  so  was  a  cathartic  of  calomel  Hnd 
jalap,  or  sulphate  of  soda.  Where  a  cough  was  troublesome,  a 
tea-spoonful  of  equal  parts  of  antimoniul  wine,  and  compound 
tincture  of  opium,  was  beneficial  to  remove  the  irritation  on  the 
luugs,  after  fever  had  subsided. 

It  has  been  already  observed,  the  sudden  rhange  of  weather 
in  October  introduced  additional  forms  of  disease  among  th« 
men.  We  have  to  notice  one  of  more  I'ormidal  le  and  more 
questionable  8ymi)tom8;  i>>kujuin.ia,  or  inflammation  within  the 
breast.  This  disease  w:is,  in  some  instances,  accompanied  with 
diarrhoea;  or  superveneil  where  diarrluea  previously  existed; 
which  last  disease  had  not  entirely  diaappeared.  The  aliove 
oomiiination  of  morbid  actions,  never,  or  st  blom  occurs  in  do- 
mestic practice,  in  the  New-England  states.  The  following 
were  the  most  prominent  symptoms  ;  piiin  in  the  .  hrsi ;  in  some 
cases  one  side,  in  others  both  were  aflecled  ;  short  and  difficult 
respiration ;  dry  cough ;  the  pul?e  of  those,  whose  condition  was 
most  alarming,  was  small  and  hard ;  the  heat  of  the  body  and 
extremities  not  above  the  standard  of  health,  sometimes  below. 
The  above  symptoms,  with  diarrhoea,  whichi  in  a  few  instances, 
attended,  seemed  to  forbid  the  employment  pf  the  lancet ;  but 
subsequent  practice  justified  its  use.  When  this  remedy  wag 
omitted,  other  auxiliaries  were  of  little  or  no  benefit.  A  ques- 
tion at  this  period  was  made,  whether  there  can  be  a  state  of 
inflammation,  where  the  heat  of  the  body  and  extremities,  at  the 
early  onset  of  the  disease,  is  below  that  of  health,  and  the  pulse 
email.  The  success  which  followed  eleven  successive  bleedi 
ings  of  four  ounces  each,  in  a  case  of  the  above  description,  dem- 
q(0^rated  the  a^rmativcv    This  was  a  soldier  of  the  25tb  regi-, 


CAMPAIGN  OP  181B. 


If 


in<>Dt,  viho  wat  admitted  iuto  the  huBpital,  arier  havini;  been 
bled  aixtrcn  ounces  nt  one  time,  by  hit  own  surgeon  or  r«f;i> 
inent;  and  who,  when  he  accompanitrd  the  man  into  (he  ho8|ii- 
(al,  obaerved,  tliat  bleeding  had  been  employe*),  as  far  ai  the 
condition  of  the  man  would  Justify.  This  was  also  my  opinion, 
upon  tirst  examination  of  the  cese ;  but,  after  all  other  means 
had  failed  to  procure  .elief,  and  the  oppression  still  continuing 
upon  the  breast,  bleeding  was  again  employed,  and  repeated. 
Arterial  action  in  this  instance  was  not  increased,  ns  the  ves- 
sels w^re  unloaded  by  blood-letting,  as  was  often  the  case.  The 
pulse  however,  did  not  sink,  but  remained  stationary.  Encour- 
agement was  therefore  given,  to  pursue  depletion  with  caution; 
until  difficult  respiration  was  removed.  This  practice  was  at 
first  adopted  as  a  Justifiable  experiment,  in  a  most  deB[ierate 
case.  Calomel,  antimonials,  and  blisters  were  freely  employed 
through  the  course  of  the  disease. 

This  disease,  when  it  first  appeared  at  Greenbush,  was  not 
considered  as  being  connected  with  an  epidemic  stMti  of  atmos- 
phere. The  following  theory  was  suggested  by  the  extraordi- 
nary symptoms,  under  which  the  disefise  apjeared.  Long  and 
unremitted  exposures  to  cold  in  tents  overcame  the  action  of 
the  arteries,  at  their  minute  extremities.  The  caloric  upon  the 
Burface  of  the  body  was  expended  more  rapidly,  than  it  wag 
evolved  by  the  vital  powers;  while  the  pulmonic  vessels  be- 
came crowded  with  blood,  and  extravas'Ued  blood  mixed  with 
mucus  formed  congestions  within  the  bronchise.  The  heart  gorged 
with  blood,  struggled  with  diminished  efforts  to  remove  its  load, 
and  the  whole  system  was  pervaded  with  torpor.  Whs  this  a 
state  of  inflammation  ?  The  symptoms  did  not  correspond  with 
those,  common  to  inflammation ;  while  dissections  demonstrated 
similar  morbid  appearances,  on  the  important  organs  of  life, 
which  are  connected  with  well  known  symptoms  of  inflamma- 
tion.    (See  note  c.)  -    •  '  *. :   ^ 

What  is  inflammation,  but  a  repletion  of  the  sanguiferous  vessels 
of  some  animated  organ ;  and,  iu  some  instances,  an  elonga- 
tion of  its  component  vessels,  having  the  appearance  of  being 
HG^  formed.    Xbia  repletion  commences  at  a  point  of  resist* 


»i 


r' 


'If' 


f 


18 


MEDICAL  BKETCHEfl. 


ancr  to  the  circiilaf'on  in  the  minute  arterirg,  prodiiced  on  the 
first  attacli,  by  a'  ttraction  oi'  caloric.  Thin  is  most  evident, 
hy  the  gradual  enlargement  or  the  diseased  parts,  with  pain  and 
liiKher  degrees  or  heat,  which  usually  accompany  the  local  dis- 
cHse.  The  piiin  of  distension  is  a  stimulus,  whitji,  in  common 
cases,  excites  Ity  nasOciation  the  heart  and  arteries  to  increas- 
ed action;  these  are  the  most  common  phenomena. 

To  tallt  of  iulliimmalion  where  there  is  no  inorensed  heat,  is 
considered  paradoxical.     Is  it  diflicult  to  understand,  that  wheie 
the  Itlood  vessels  are  greatly  surcharged,  or  gorged,  the  nervous 
filaments,  immediately  connected  with  the  gorged  vessels,  might 
by  their  compression,  be  deprived  of  their  inherent  powers  of 
communicating  sensation,  and  become  insusceptible  of  pain ; 
and   that  a  torpor,  accompanied  with  coldness,  or  death  of  thn 
part,  may  follow  ?   By  depletion,  the  compression  is  removed, 
the  vessels  resume  their  action,  the  pulse  becomes  more  full, 
pain  is  increased,  and  a  glow  of  heat  is  gradually  ditTused  through- 
out the  whole  system.     This  state  is  unquestionably  inflamma- 
tion.    Will  that  state,  wiiich  preceded  depletion,  be  considered 
less  inflammatory,  or  less  disposed  to  inflammation?  When  tliere 
is  compression   on  the  bruin,  the  source  of  sensorial  power  is  im- 
paired, and  the  mental  faculty,  immediately  connected  with  it, 
suspended.     Whereas,  when  the  compression  is  upon  the  ner- 
vous filaments  of  an  org^in,  less  connected  with  life,  as  the  lungs 
or  liver,  the  meiUal  faculty  does  not  immediately  sufler,  and 
may  not  be  impaired,  even  at  the  point  of  death.     Those,  who 
fell  victims  to  this  most  violent  form  of  pneumonia,  retained 
their  senses  to  the  last  mo.Tient.  How  is  torpor,  the  consequence 
of  a  gorged  state  of  the  lungs,  to  be  overcome  ?    Wot  by  stimu- 
lants, while  the  engorgement  exists ;  because,  if  the  nervous 
filaments  are  susceptible  of  the  least  sensation,  and  the  gorged 
blood  vessels  connected  with  them  capable  of  being  excited, 
their  state  of  engorgement  will  (hereby  be  confirmed ;  while  a 
disease,  already  most  dangerous,  will  become  irremediable.  But, 
by  removing  the  compression  by  bleeding,  the  nervous  filaments 
may  recover  their  powers  of  sensation,  if  those  powers  have  not 
beea  too  long  interrupted ;  while  excited  arterial  actioo,  and 


CAMPAIGN  OF  1812. 


If 


jneretBcd  pain  which  eniuo,  ar«  evUt«ace  that  one  point  i« 
gained ;  and  by  further  depleliona  cautiously  employed,  difficult 
ret|»iration  is  overcome  ;  bo  as  the  system  may  lie  restored  to  a 
state,  in  which  mure  obvious  remedies  are  indicated.  The  sub- 
ject matter  of  the  above  form  of  disease  will  b«  more  fidly  con- 
sidered, when  its  most  violent  forms,  as  they  appeared  the  fol- 
lowing winter,  shall  be  more  particularly  described. 

A  particular  history  of  the  states  of  disease  amoii^;  the  troops 
on  the  frontiers,  from  September  to  the  last  of  December,  can- 
not he  given  in  detail.  It  was  reported  Ity  the  Buri;eons  attached 
to  regiments,  that  dysentery,  diarrhoea  nnd  fever,  continued  to 
attack  the  men.  The  most  prevailing  disease,  with  which  the 
right  wing  of  the  army  was  afflicted,  when  it  was  encamped  at 
Plattsburgh,  and  Champlain,  was  the  measles.  It  wus  stated, 
nearly  one  third  of  the  troops  were  seized  with  this  disease.  It 
was  accompanied  with  symptoms  more  severe,  as  the  weather 
became  colder,  in  the  month  of  Noveml)er  :  while  the  conva- 
lescents from  it  were  predisposed  to  the  reception  of  a  disease, 
under  the  form  of  i>ne(;moma;  and,  in  conjunction  with  an 
epidemic  state  of  atmosphere,  and  other  more  obviouo  i  ~iting 
causes,  the  army,  generally,  were  aulijected  to  its  most  violent 
forms.  A  catarrhal  alTection  at  that  time,  (.Innuury  1st,  1813,) 
was  universal  among  the  men.  Tiiis  epidemic  was  first  noticed 
at  Greenbush  cantonment,  the  last  of  October,  ns  has  been  be- 
fore observed.  In  proportion  to  increase  of  cold,  this  disease 
became  more  frequent  and  severe. 

It  may  be  necessary  to  observe,  the  winter  epidemic  of  1812, 
13,  was  a  form  of  disease,  distinct  from  that,  which,  in  the  north- 
ern districts  of  the  eastern  states,  the  preceding  winters,  hnd 
been  known  by  the  name  of  spotted  fever ;  although  the  exciting 
causes  may  have  been  similar.  I«  the  spotted  fever,  mental  de- 
raugement  was  an  almost  general  concomitant  of  the  disease. 
In  many  instances,  this  affection  of  the  bram  was  the  first  symp- 
tom of  morbid  action.  Whereas,  pneumonia,  es,)ecially  among 
the  troops,  was  never  accompanied  with  mental  derangement,  at 
its  first  attack,  and  but  seldom  in  its  more  advanced  stages ;  nor 
ubtil  the  laborious  r^'spiratioo,  which  was  a  most  prominent 


20 


MEDICAL  SKETCHES. 


tymptom,  at  the  first  attack  bad  somewbat  subsided,  or  the  p* 
tient  at  the  point  r^i  death.  f  '  :^j:  j  '^'  ^l^  ; ..  "  i  \^r.*\  ?  I-M^vt 
'■■  This  epidemic  appeared  under  the  forms  of  both  sthenic  and 
asthenic  diathesis ;  altbouj^h  under  the  last,  it  was  often,  if  not  al' 
nvays,  deceptive ;  which  led  the  physicians,  in  many  instances, 
to  a  most  incorrect  practice  ;  a  practice  which  never  mitigated 
the  rvmptoms,  but  always  precipitated  the  patient  into  an  incur- 
able state.  The  varieties  of  this  disease  induced,  depended  on 
prior  habits  and  temperaments.  In  many  of  the  first  cases  at 
Burlington,  where  General  Chandler's  brigade  had  taken  quar- 
ters for  the  winter,  (where  I  was  a  spectator  of  its  ravages)  the 
disease  proved  fatal,  in  two,  three,  and  four  days,  by  the  vio- 
lence of  the  first  attack ;  in  some  instances,  in  less  than  twenty- 
four  hours,  after  the  first  symptoms  of  indisposition  supervened. 
A  soldier,  attached  to  the  hospital  as  a  nurse,  complained  that 
he  had  taken  cold,  and  that  he  feu  an  oppression  at  his  breast ; 
so  little  was  his  indisposition,  that  he  went  to  the  lake  shore, 
distant  sixty  rods,  returned  with  two  buckets  of  water,  flung 
himself  on  his  bed,  and  died  in  six  minutes,  apparently  in  a  state 
of  suffocation.  There  wero  other  instances  of  deaths,  almost 
as  sudden. 

The  following  were  the  most  coLspicuoas  features  of  the  dis- 
ease, under  its  most  deadly  form.  At  the  first  attack,  the  heaC 
of  the  body  and  extremities,  were  below  the  standard  of  health ; 
the  pulse  contracted  and  hard ;  sometimes  scarcely  perceptible  r 
respiration  extremely  laborious ;  not  apparently  so  much  froni^ 
sharp  pains  tht'ough  the  sides  and  breast,  as  from  a  sense  of  suf> 
fbcation.  The  patients  say,  upon  enquiry,  that  they  do  not  suf- 
fer from  extreme  pain,  but  a  weight  upon  the  chest ;  an  oppres- 
sion from  inability  to  inhale  the  air ;  a  sensation,  oue  might  im- 
agine, similar  to  that  which  might  be  produced  by  breathing  air 
deprived  of  its  oxygene.  The  suffocation  on  the  first  attack  may 
be  accounted  for,  by  Supposmg  the  lungs  in  a  condition  which 
rendered  this  organ  incapable  of  ai)sorbing,  or  transmitting 
through  its  membranes,  the  vital  principle  of  the  atmospheric  air ; 
or,  in  consequence  of  the  engorgement  of  the  bronchtse,  the  air 
^as  excluded  from  their  smaller  ramif.catiou9.    This  state  oT 


CAMPAIGN  OP  1812. 


21 


the  Itincs  wns  made  m  >st  evident,  by  many  dissections  of  those, 
who  hiul  died  l»y  the  dispose.  The  appearances  were  engorge- 
m»<nt8,  coni^tsliutis,  and  iiiflimmiitions ;  even,  where  there  wag 
previous  to  death  no  incrcse  of  heat.  The  bronchiie  were 
ch;irged  with  a  mixture  of  blood,  and  mucus.  Where  the  dis< 
ensc  hnd  Iteen  of  some  duntion,  adhesions  of  the  lungs  to  the  cir- 
cumjacent parts  were  noticed.  The  spongy  texture  of  this  vis^ 
CUB  was  lost ;  while  it  assumed  in  some  measure,  the  solid  and 
comttnct  slate  of  the  liver.  It  w?«s  sometimes  covered  with  a 
yellowish,  glutinous,  extravasate.  9uid,  which  adhered  with 
some  force  to  its  surf  ice. 

John  Bell,  has  given  a  description  of  a  similar  disease,  which 
appeared  in  Europe.  The  appearances  of  the  viscera,  as  delin* 
eated  by  him,  so  exactly  correspond  with  those  which  fell  under 
our  oiiservation,  during  the  prevalence  of  the  winter  epidemic  of 
lo!2-]3,  that  his  accot*nt  of  it  will  be  here  subjoined.  It  ma^ 
convince  those  of  their  error,  who  believed  that  the  epidemic 
was  a  new,  or  an  anomalous  disease. 

"  In  the  peripneumonia  notha,"  Bell  observes,  **  there  is  not 
merely  an  inflammation  uf  the  pleura,  as  the  name  expresses, 
but  of  the  lungs  themselves ;  and  it  is  not  from  inflaramation» 
pain,  fever  or  acute  suffering  that  they  die,  but  because  the  lungs 
are  entirely  crammed  with  blood;  the  heart  can  no  longer 
move ;  they  (the  patients,)  are  not  sensible  of  their  dangerous 
state,  but  are  suffocated  in  a  moment,  and  die  without  a  groan. 
It  seems  more  frequent  in  other  countries,  than  in  this,  (Grcnl- 
Britain,)  although  no  country  is  exempted.  When  this  disease 
comes  u[>on  a  place,  it  comes  with  all  the  frequency  and  de- 
struction of  an  epidemic  disease ;  and  the  sudden  and  unexpect- 
ed deaths  are  terrible."  In  like  form,  it  appeared  in  the  army 
on  the  frontiers ;  and  with  no  less  violence  were  its  attacks 
inade  upon  the  inhabitants  scattered  over  a  very  extensive  dis- 
trict of  country,  from  lake  Erie  down  to  lake  Champlain;  over 
Vermont,  the  northern  counties  of  Connecticut,  Massachusetts., 
and  New-Hampshire. 

"  The  pulse  is  weak,"  continues  Bell ;  "  the  cough  is  slight  j 
the  difficulty  of  breathing  more  aaxious  than  painful,  ariBing 
4 


\  \ 


se 


TVIEniGAL  SKETCHES. 


Ill 


t  ■! 


from  Inability  fo  inhale  «he  nir ;  the  face  sunk  in  the  rpatnpea,  and 
flusiied,  or  rather  of  a  hirid  colour,  exce|»!  w'len  c-Hifiveroiia,  i)ale 
andsiDow;  the  sii'Tocatlon  is  sudden  ;  the  lunffs  have  a  liver- 
like  solid  consistenf^e  ;  they  have  no  longer  the  cellnl'ir  apnear- 
ance  of  hin;r8 ;  for  their  hronchiae  are  crammed  with  hlood ; 
their  common  celliil  «r  texture  is  also  full  of  exuded  hlood;  they 
are  dense,  solid  ai.d  heavy,  and  they  sink  in  water.  The  heart 
is  30  curbed  in  its  action,  that  it'gives  liut  a  sm  dl.  fcehle,  Iremb- 
liujQj  pulse;  and  even  i:  ii  few  days,  the  heart  is  woinlerfidly 
diluted  Hud  enlar£;ed,  aiul  fdled  with  fluid  and  grumous  Idood." 

The  physician,  in  these  cases,  hesitated,  and  cauTniusly  era* 
ployed  the  lancet.  Here  however,  it  may  he  necess  iry  lo  olj- 
aerve,  that  there  were  two  states  of  this  most  dangerous  form  of 
disease,-  which  were  somewhat  similar,  as  reg  irds  the  pulse, '  ut 
which  were  essentially  different.  In  one,  with  its  apparent 
Hveakcess,  there  was  a  hardness  ;  it  was  called  a  rontracted  h  ird 
pulse,  hy  some  a  siifled  pulse,  and  should  he  distinguished  f/ora 
the  other,  which  was  weak  and  soft ;  in  both,  the  pulse  was 
«mall. 

,  In  the  first  state,  accompanied  with  most  laborious  and  suffo* 
cated  respiration,  there  was  fio  expectoration,  nor  much  pain  in 
the  chest.  Here  a  cautious  use  of  the  lancet  was  required. 
Here,  not  only  the  pulmonic  vessels  were  crowded  with  blood, 
but  the  bronchisB  were  loaded  with  bloody  mucus ;  the  heart 
«nd  arteries  ceased  to  act,  not  because  they  were  debilitated, 
but  because  they  were  surcharged  with  blood.  This  state  was 
attended  with  coldness  and  torpor.  Heat  could  not  be  perma- 
nently restored  by  any  means,  but  by  the  abstraction  of  blood,  at 
the  commencement  of  the  disease.  Blood  however,  should  be 
taken  away  with  caution.  When  bleeding  was  employed  to  the 
quantity  of  four  or  six  ounces,  at  short  intervals  of  four,  six,  oc 
eight  hours,  it  gave  the  gorged  vessels  0[iportunity  to  free  them- 
selves from  the  0])pres3ive  load;  and,  more  certainly,  when 
warm  applications  had  been  previously  made  and  continued 
upon  the  surface  and  extreniities  of  the  boily.  By  the  above 
Qieans,  the  pulse  became  fuller  and  heat  was  restored ;  when  a 
Tail  Weei'ln§  mgbt,  in  some  cases  he  employed,  not  oaly  witK 


CAMPAIGN  OP  1812. 


J 


enPfty,  hut  with  benefit.     As  soon  as  warmth  and  the  circulat'ioE 
6f  the  blood  were  reslored  to  the  surface  and  extremities,  the  ' 
patient  was  considered   in  a  curable  condition ;    wherein,   ap^ 
pro!)rinle   reinctlies  mi!j;ht   be  administered  ;  beins  such  as  arft 
Bsudly  em')loved  in  uneumonic  affections  with  fever. 

In  crises  where  death  had  immediately  followed  the  above 
firm  ttoms  of  contracted  hard  pulse,  torpor,  and  2;eneral  cold- 
ness, varioiis  dissections  have  demonstrateil  the  highest  state  of 
distention  of  the  pulmonic  vessels,  with  'dood  ;  and  of  '  chi- 
al  enijorirem'Mit  with  bloody  mucus.  The  lungs  assL  1  the 
appearance  of  inll  immition.  By  what  menns  m  ly  these  formi* 
^  ihle  congestions  within  that  congeries  of  air  and  blood  vessels, 
of  which  the  lungs  are  composed,  be  resolved,  except  by  bleed- 
ing? Without  the  employment  of  the  lancet,  other  auxiliary 
remedies  proved  ineffectual.  The  bleeding  should  l)e  small  and 
repeated,  until  the  pulse  becomes  fuller,  and  the  heat  of  the  body 
]s  increased  above  the  healtiiy  standard ;  when  the  patient  may 
bear  a  larger  quantity.  The  patient  sometimes  fainted  with  the 
loss  of  eight  ounces  of  blood  at  first ;  who,  subsequently,  was  bled 
sixteen  ounces,  without  any  collapse  of  the  vessels.  The  num- 
ber taken  down  with  this  most  formid able  state  of  disease  was 
few,  comjiared  with  the  m  dtitude  seized.  A  fortunate  adminis* 
tration  of  stimulants,  in  a  solitary  Instance  only,  within  my 
knowledge,  proved  successful ;  while  their  indiscriminate  use 
induced  a  most  deadly  practice.  Such  was  the  practice  in  (he 
army,  for  a  short  period.  Brandy,  wine,  and  soups  were  the 
remedies  administered,  in  every  form  of  these  pneumonic  affec- 
tions. Prior  to  these  potent  stimulants,  emetics,  cathartics,  and 
blisters  were  em;)loyed.  The  iancet  was  prohibited  under  ev* 
«ry  form  of  this  epidemic. 

It  has  been  ol)served,  the  physicians,  at  the  first  appearance 
•f  this  epidemic,  doubted  the  propriety  of  bleeding.  Their 
doubts  were  removed  by  the  superior  success  which  followed 
the  use  of  the  lancet;  while  stimulants  proved  fatal.  It  is  wot^ 
thy  of  notice,  in  two  cases,  which  came  under  my  obseivation, 
where  blood-letting  was  cautiously  employed,  the  providential 
ojpeolD^  of  the  orifice^  during  a  restless  night,  produced  so  rnueh 


¥k 


u 


ilEDICAL  SKETCHES. 


relief,  (even  the  removal  of  every  alarming  symptom)  as  led  to 
a  persuasion,  that,  in  some  instances,  where  the  disease  hud 
proved  fatal,  bleeding,  from  too  great  timidity,  had  been  imi^rop* 
criy  neglected ;  and,  in  others,  employed  with  too  much  cuu- 

tiOQ. 

The  above  form  of  this  epidemic  was  considered  by  some, 
typhoid,  or  asthenic.  A  typhous  fever  is  always  accomiianied 
fvith  a  prostration  of  strength,  and  low  delirium.  Will  a  disease 
be  considered  typhous,  where  the  patient  is  able  to  vralk  the 
room,  and  continue  this  exercise,  even  a  few  minutes  previous 
to  death  ?  Is  that  disease  typhous,  which  is  relieved  by  bleed- 
ing ?  This  form  of  the  disease,  in  some  cases,  demanded  as  ma- 
ny ounces  of  blood,  in  the  course  of  the  treatment,  as  is  often 
drawn  from  a  person  in  severe  pneumonia,  accompanied  with 
high  degrees  of  heat,  strong  arterial  action,  and  acute  pain.  Yet, 
in  this  uncommon  form  of  disease,  it  was  inexpedient  to  take 
more  than  two,  four,  six,  or  eight  ounces  at  once.  The  above 
quantities  were  taken  away,  every  two,  four,  or  six  hours,  pro 
re  nata  ;  until  permanent  relief  was  procured.  Sometimes  after 
tlie  first  bleeding,  the  pulse  became  fuller,  and  the  heat  of  the 
body  increased.  This  favourable  circumstance,  however,  did 
not  usually  follow,  until  after  the  third,  or  fourth  bleediug.  It 
was  not  arterial  action,  but  the  state  of  respiration  which  gov- 
erned the  employment  of  the  lancet  in  this  form  of  disease. 
Whenever  the  tepid  bath  could  be  employed,  it  proved  benefi- 
cial, in  the  cold  and  torpid  state  of  the  system,  to  restore  warmth 
to  the  surface  of  the  body,  and  action  to  the  extreme  vessels. 

The  progress  of  this  form  of  the  diseuse,  was  most  rapid.  It 
assumed  in  a  few  hours  the  strongest  marked  symptoms  of  dis- 
solution. It  may  be  added,  that  even  when  sulTocatioii  and  rat- 
ling supervened,  and,  at  the  moment  death  was  closing  the 
scene,  and  the  heart  and  arteries  ceased  to  perform  their  offices, 
that  muscular  strength  was  not  remarkably  impaired  ;  nor  was 
the  mind  deranged.  The  conflict,  exhibited  in  some  instancet 
by  the  patient,  was  most  distressing.  Several  have  been  seen 
to  -walk  the  room  a  few  hours,  and  even  a  few  minutes^  previous 
to  death ;  possessing  a  keen  sense  of  their  irremediable  state,  and 
inevitable  dissolution. 


CAMPAIGN  OP  1812, 


ed 


The  number  taken  down  vith  this  most  formiilable  state  of 
the  epidemic  were  few,  compared  with  the  multitude  seized. 

Id  the  second  state  of  the  disease,  and  wliere  there  was  a 
weak  sort  pulse,  bleeding  was  injurious  ;  yet  the  antiphlogistio 
regimen  was  necessary.  Here  the  respiration  was  dithcult, 
but  not  BuQbcated  ;  accompanied  with  pain  in  the  side,  and  ex- 
pectoration of  bloody  mucus ;  the  bronchiae  were  not  so  crowd- 
ed, as  to  be  incapacitated  to  free  themselves  from  the  load 
with  which  they  were  oppressed;  the  heat  of  the  body  waa 
never  much  above  the  common  standard  of  health.  This  form 
of  the  disease  was  frequently  accompanied  with  diarrhoea; 
where  drastic  purges  were  prohibited,  and  milder  cathartics  ad- 
ministered with  great  caution.  The  diarrhoea,  at  times,  was  so 
profuse,  that  cathartics  were  injurious ;  while  it  was  necessary 
to  check  these  alvine  discharges  by  opium.  The  diarrhoea, 
which  accompanied  the  disease,  was  not  critical ;  nor  was  it 
shecked,  as  the  fever  abated,  except  by  opium ;  continuing  ob* 
stinate,  in  some  instances,  efter  return  of  appetite.  This  per- 
verse diarrhoea,  according  to  the  report  of  Doctor  Lovell, 
yielded  to  lime-water.  Emetics  of  ipecacuanha,  were  beneficial 
to  promote  expectoration;  and  repeated  blisters  of  the  highest 
importance  to  counteract  pain.  Stimulants  were  improper,  uo* 
til  difficult  respiration  was  removed,  and  expectoration  became 
copious.  During  convalescency,  wine  in  small  quantity,  wan 
an  appropriate  remedy,  and  grateful  to  the  patient. 

The  above  forms  of  the  disease  were  similar  to  the  pneumonUL 
notha  of  the  ancients.  It  is  not  unworthy  of  notice,  that  its  at- 
tacks were  most  severe  upon  those,  who  were  in  habits  of  intent 
perate  potations  of  spirituous  liquors.  * 

The  third  form  of  this  disease  shewed  itself  with  less  ques* 
tionable  symptoms.  At  the  first  onset  of  the  disease,  there  were 
strong  rigors,  with  acute  pain  through  the  chest.  The  rigors 
were  soon  followed  by  much  heat,  strong  pulse,  cough,  and  no 
expectoration.  The  efforts  of  coughing  always  increased  the 
pain  in  the  breast.  The  above  symptoms  promptly  demanded 
blood-letting  from  sixteen,  to  thirty-two  ounces.  If  any  mitiga- 
tieu  was  procured  by  this  operation,  some  expectoration  of  mu* 


\i  1 


I 


s» 


MEDICAL  SKETCHES. 


'  I 


cutt  sfreaked  with  blood  followed  Evening  exncerhntiona  fre'* 
^uf  ntly  required  a  repetitioo  of  the  luncet.  In  a  few  instances, 
two  qunrts  were  drawn  from  the  arm  of  the  patient,  in  forty- 
sight  hours,  with  (  best  effect — the  removal  of  every  alarm- 
ing symptom. 

But,  when  this  mosi  nportant  remedy,  bleedinp  was  omitted, 
the  patient  most  generally  died  in  the  first  stage  of  the  disease, 
ivifh  an  abscess  within  the  lungs;  or,  if  he  survived  the  bursting 
•f  the  abscess,  life  was  firotracted,  possibly,  some  weeks ;  when 
ibe  died  with  hectic  emaciation. 

The  following  case  ia  interesting.  A  physician,  who  joined 
the  army,  at  a  late  period  of  the  epidemic,  observed,  that  by  the 
aid  of  emetics,  cathartics,  blisters,  and  calomel,  in  large  and 
imall  doses,  without  blood-letting,  he  was  able  to  cure  the  fever. 
The  importance  and  necessity  of  this  evacuation  was  forcibly 
irged.  Notwithstanding,  he  obstinately  persisted  in  his  own 
plan  of  practice,  until  four  of  bis  first  patients  had  succumbed 
Huder  his  prescriptions.  The  fifth  was  an  interesting  young 
man,  who  had,  during  a  former  sickness,  been  attended  by  ray- 
eelf.  The  fourth  day  after  he  was  taken  down,  and  when  recov- 
ery was  despaired  of  by  his  physician,  I  was  called  in  consulta- 
tion. The  case,  at  this  period,  was  most  desperate ;  when  my 
opinion  was  unreservedly  given,  that  bleeding,  at  an  earlier 
fltage,  would  have  saved  his  patient.  If  so,  why  will  you  not 
bleed  him  now,  replied  his  physician.  Because  bleeding,  under 
his  circumstances,  had  become  an  uncertain  remedy ;  and,  in  as 
much  as  the  reputation  of  this  evacuation  was  but  recently  es- 
tablished, as  a  remedy  in  this  disease,  it  would  be  reluctantly 
employed  by  myself,  in  a  case,  where  it  was  my  strong  appre- 
beusion,  it  would  not  succeed.  In  this  case,  as  the  disease  had 
been  of  four  days  duration,  with  a  full  soft  pulse,  laborious  res- 
piration, and  a  hectic  flush  on  the  countenance,  my  persuasion 
was,  that  suppuration  had  supervene<I  on  the  lungs.  Upon  the 
point  of  retiring  without  making  a  prescription,  the  patient,  with 
ts'ild  emotions,  feebly  articulated,  will  you  leave  me  thus  ?  Bleed 
me»  or  death  is  my  fate!  Yes,  you  shall  be  l>led,  was  my  reply. 
The  anxious  looks,  with  mixed  expression  of  anguish  and  re^ 


mwm 


CAMPAIGN  OF  1812. 


fir 


proof,  nnd  tone  of  despair,  sunk  deep  into  mj  heart ;  it  wns  like 
an  electric  shock  to  my  frame.  The  Teelings  of  responsiUility 
DO  longer  opposed  the  emotiuns  of  sensibility,  all  fictive  for  (he 
fate  of  the  amiable  young  man.  He  was  immediately  bled  six* 
teen  ounces.  The  following  day  sixteen  ounces  were  again  tak- 
en away.  Bleeding  was  repeated  to  the  amount  of  seventy 
ounces  in  four  days;  when  he  convalesced,  was  able  to  leav© 
his  bed  some  hours  in  the  day,  and  walk  his  room,  with  a  re- 
turning appetite.  Orders  at  this  time,  to  march  to  a  distant  post, 
precluded  me  from  knowing,  whether  his  health  was  fully  rein- 
stated, or  whether  it  deteriorated  to  a  hectic  decline;  which 
might  have  been  expected,  from  the  profuse  ex|>ectorationS| 
which  succeeded  the  resolution  of  inflamm:ition  within  the  breast. 
A  cathartic  of  calomel  and  jalap,  or  calomel /;(?r  .ve  was  admin- 
istered, after  the  first  bleeding,  in  this  form  of  disease.  This  it 
was  necessary  to  repeat.  As  soon  as  the  fever  with  pain  was 
reduced  by  bleeding,  and  cathartics,  calomel,  and  tartrite  r)f  an- 
timony were  given,  with,  or  without  opium,  to  pnimote  ex|»ecto- 
ration;  and  when  a  gentle  spitting  wns  produced,  the  remiine 
of  pain  in  the  breast  gradually  removed ;  ditficult  respiration 
abated,  and  a  gentle  moisture  upon  the  skin  supervened.  Equal 
parts  of  antimooial  wine,  and  compound  tincture  of  opium,  prov- 
ed an  excellent  medicine,  in  this  state  of  the  disease.  When 
the  antimony  occasioned  too  loose  a  state  of  the  bowels,  Dover^s 
powders,  in  small  doses,  were  sulrstituted.  After  the  inflamma- 
tory state  of  the  disease  was  subdued,  by  the  above  means,  es- 
pecially, where  nausea,  er  anorexy  existed,  emetics  of  ipecacu- 
anha, were  advantageously  administered  ;  with  intention  of  pro- 
moting expectoration,  and  determining  the  circulation  to  the 
extreme  vesselr  Blisters,  in  the  course  of  the  disease,  were  in- 
dispensable to  remove  stiches  in  the  breast  and  sides,  after  blood- 
letting was  carried  to  its  full  extent;  believing  with  others,  that 
'^  there  is  a  blistering,  as  well  as  a  bleeding,  and  emetic  period  in 
fevers ;  the  bounds  of  which  being  ascertained,  should  never  be 
intruded  upon  by  each  other. 

Where  stimulants  were  demanded,  as  they  never  were  while 
%ere  was  difiicult  resplratioo}  a  mixture  of  spirit,  nitii  il\ih 


IJI 


M 


'  "t 

1 


■.ft 


1^ 


11 


m 


28 


MEDICAL  SKETCHEJI. 


If 


I  ,1 1 


and  aqua  ammonia,  six  parts  of  the  first,  and  one  of  the  last,  viM 
an  appropriate  medicine.         '  '      ^  •  '  •  '  i 

Coughs,  in  a  few  instances,  were  obstinate,  after  there  was 
a  resolution  of  fever.  These  were  gradually  subdued  by  a  tea- 
spoonful  of  a  mixture  of  equal  parts  of  antimonifLI  wine  and  com- 
pound tincture  of  opium,  administered  every  four  or  six  hours, 
pro  re  nata ;  or  as  often  as  the  urgency  of  the  cough  required. 
Mucilaginous  drinks  sweetened  with  honey,  or  liquorice,  were 
directed  in  all  forms  of  the  disease.  Hcctick  emaciations,  and 
gradual  decay,  in  some  instances,  followed  Chis  epidemic.  Some 
few  were  to  be  found  in  our  Iios|>ital8,  twelve  months  after  the  fimt 
attack  of  the  disease,  where  death  eventually  closed  the  scene. 
During  which  period,  infirm  life  was  chequered  with  revivinjp 
hope,  painful  anxiety,  and  severe  distress. 

More  dependence  was  placed  upon  a  dietetic  management,  to 
restore  the  convalescents  to  health,  than  difTusable  stimulants. 

Bleeding  was  opposed  in  cases  of  attack  of  this  epidemic,  at 
the  time  of  its  first  appearance,  by  some  physicians  of  respecta- 
bility, in  the  vicinity  of  the  army.  A  warm  interest  was  excit- 
ed against  the  practice,  at  Albany ;  where  the  epidemic  was 
considered  by  some,  as  a  malignant,  bilious  fever. 

The  first  case,  which  was  reported  by  a  physician  at  that 
place,  was  of  a  citizen,  who  was  takei.  ill  at  Greeubush  encamp- 
ment. This  was  represented  as  a  bilious  fever,  of  a  malignant 
type.  This  case  was  examined  by  some  of  the  medical  gentle- 
men of  the  hospital,  previous  to  his  removal  to  Albany;  who 
stated  to  me,  that  he  did  not  labour  under  all  the  symptoms, 
which,  in  the  hospital,  were  denominated  pneumonia;  under 
which,  without  the  use  of  the  lancet,  few,  if  any  recovered.  The 
above  man  was  bled,  and  died  under  the  hands  of  his  physician, 
who  adduced  this,  as  a  case  where  bleeding  did  not  succeed. 
Incorrect,  or  not,  the  above  case  proved  nothing  against  bleeding. 
As  it  was  well  understood,  that  many,  attacked  with  the  real  ep- 
idemic, died  under  the  prescription  of  the  same  physician,  who 
were  not  bled. 

That  an  epidemic  should  have  assumed  an  appearance  some- 
what different  in  form,  among  citizens  in  a  cify,  svith  an  exteji^ 


CAMPAIGN  OP  1812.  ^ 

live  population,  rrom  that  in  camp,  produced  by  the  same  remote 
and  predisposing  causes,  may  be  readily  accounted  for,  from  the 
circumstance,  tliut  epidemic  diseases  are,  generally,  mont  preva- 
lent among  that  class  of  citizens  of  every  age,  sex,  and  constitut 
tion,  whose  circumstances  in  life  do  not  admit  them  to  the  en* 
joyment  of  all  tiie  necessnrios  and  comforts,  for  healthy  BU|)|)ort<. 
Cold  lodgings,  coarse  and  spare  diet,  and  dirty  houses,  predis- 
pose the  body  to  a  form  of  disease,  somewhat  different  from  Ihav 
which  appears  among  men  fed  with  a  full  ration  of  animal  food^^ 
and  superabundance  of  ardent  spirits. 

It  was  a  fortunate  circumstance,  that  there  was  no  essential 
difference  of  opinion,  as  to  the  nature  of  the  disease,  and  method 
of  practice  among  the  physicians  of  the  army,  after  it  was  well 
understood.  Its  nature  had  been  anticipated,  before  demonstra- 
tions were  made  by  dissections ;  so  that  the  daily  employment 
of  bleeding,  and  its  attendant  success  warranted  a  continuance 
of  the  practice,  in  opposition  to  preconceived  opinion,  founded 
merely  on  theoretic  doctrines.  ,  w  .1, 

The  predis|)osing  causes  of  extensive  endemic  diseases,  are 
involved  in  obscurity.  They  are  not  confined  to  any  season. 
An  epidemic  state  of  atmosphere,  is  known  by  effects  produced. 
When  no  obvious  causes  can  be  assigned  for  epidemic  diseases, 
astronomical  in  ^ucnces,  unsatisfactory  as  they  are,  have  beea 
resorted  to  as  causes,  by  the  poets  of  antiquity,  and  more  modr 
ern  philosophers.  Hence  comets,  in  all  ages,  have  been  viewn 
cd  as  portentous  signs,  which  forebode  both  natural  and  moral 
evils.  The  varying  aspects  of  the  planets,  have,  from  time 
immemorial,  been  consulted  upon  the  most  trivial,  as  well  as 
the  more  important  affairs  of  men.  Those  remotely  revolvr 
ing  orbs,  even  at  this  day,  are  considered  as  powerful  agents, 
operating  upon  our  globe,  and  through  the  medium  of  its  atmos- 
phere, diffusing  pestiferous  influences  on  animate  and  inanimate 
nature.  These  vagaries  and  more  elaborated  theories  are  in- 
offensive acd  pleasantly  amusing ;  but  do  not  obviate  one  evil, 
nor  bestow  one  blessing  upon  the  human  race,  even  if  they  were 
demonstrated  truths.  The  more  obvious  exciting  causes,  which 
are  more  under  our  control,  are  to  be  explored ;  that  when 
5 


i^, 


I 


^0 


MEDICAL  SKETCHES. 


!:i 


known,  th^y  may  be  obviated  ;  three  several  cames  will  be  no- 
ticed hereafter.  ' 

The  substance  of  the  above  sketches  uf  the  epidemic  vim 
published  in  the  New-York  Rcposiury  in  1R13;  more  precision 
has  been  here  observed  in  pointing  out  the  several  forms  of  the 
epidemic,  as  it  appeared  among  the  troops. 

A  remarkable  coincidence  uf  opinion,  respecting  the  natiiri* 
and  treatment  of  this  epidemic,  is  exhibited  in  the  following 
communication  of  Doctor  Hilas  Filler,  of  the  3d  Kegiment, 
when  on  the  Niagara  frontier.  It  was  first  published  in  the 
Aatn-B  at  Albany,  and  republished  in  the  Medical  Repositu- 
RY  at  New-York.  It  is  here  introduced  to  shew,  that  this  dis- 
ease was  viewed  in  the  same  light,  and  treated  in  a  similar  man- 
ner by  him,  at  the  distance  of  three  hundred  miles,  as  it  was,  at 
the  some  period,  viewed  and  treated  by  myself. 
.'  "  This  sickness,"  observes  Doctor  Fuller,  "  is  not,  as  has 
been  represented,  confined  wholly  to  the  army.  The  soldiers 
have  only  shared  in  a  wide  spreading  and  alarming  epidemic, 
l>ervading  a  vast  extent  of  country :  the  mortality  of  which  is 
without  example  in  this  part  of  (he  st»te.  The  disease  appears 
evidently  to  depend  on  some  peculiar  state  of  atmosphere,  as  a 
remote  cause  ;  and  an  exposure  to  wet,  cold,  and  fatigue,  as  an 
exciting  cause.  In  proportion  as  these  causes  have  taken  place, 
a  more  or  less  violent  form  of  the  disease  is  produced.  The 
moGt  common  form  under  which  it  has  presented  ilself,  is  that 
of  sthenic  pneumonia ;  the  most  fatal  and  unmanageable  of  the 
ptnmiom'a  7io;/{a  of  the  old  books.      •-  ^        '  ' 

"  Under  this  last  form,  it  has  but  seldom  appeared  ;  and  not- 
withstanding, it  is  evidently  produced  by  the  same  remote  and 
exciting  causes,  there  is  a  strongly  marked  difference  in  the 
phenomena  of  them. 

"  Those  advanced  in  years,  ajid  in  a  particular  manner,  those, 
who  have  weakened,  or  broken  down  their  constitutions  by  au 
intemperate  use  of  spirits,  are  sulyects  of  this  asthenic  form  o( 
this  epidemic. 

"  The  asthenic  form,  most  commonly  commences  with  cohi 
\ftci'  some  time,  tl'.cre  is  a  sense  of  heat.    In  some 


(Cring. 


seu^e 


)f; 


Ji! 


CAMPAIGN  OP  1812. 


.11 


he  DRtiirc 
Tol  lowing 
legiment, 
?d  in  the 
Ikpobitu- 
it  this  die- 
nilar  man- 
it  was,  at 

ot,  as  has 
ie  soldiers 
epidemic, 
which  is 
je  appears 
there,  as  a 
gue,  as  an 
len  place, 
ed.  The 
elf,  is  that 
ible  of  the 

and  i\ol- 
mote  and 
ce  in  the 

tier,  those, 
ons  by  au 
c  form  of 

with  col(5  ^ 
In  Bomp 


instances,  tlie  common  symptoms  or  ptrt.xia  are  noticed.  Tlie 
pulse,  however,  for  the  most  part  is  small,  and  the  heat  not  high- 
er in  degree  than  natural.  During  the  I'iourso  of  the  disease^ 
respiration  is  extremely  laborious,  with  slight  erratic  pains 
through  the  chest. 

"  A  sense  of  weight,  and  fullness  is  felt  through  the  whole 
extent  of  the  thorax,  which  arc  increased  in  an  insupportable 
degree,  while  the  patient  is  in  a  horizontal  position.  There  is 
a  peculiar  paleness  and  wildness  of  aspect  not  easily  described. 
In  some  cases,  a  diarrhti'a  adds  to  the  list  of  morbid  phenomena. 
Some  have  expired  while  sitting  and  walking,  apparently  from 
suffocation. 

"  In  the  above  described  cases,  the  lancet  has  been  employed 
with  caution.  Bleeding,  however,  has  been  attended  with  ad- 
vantage. The  pulse  has  become  fuller,  after  the  first  bleeding, 
while  its  repetition  with  other  remedies  has  completed  the  cure, 

"  An  attentive  scheme,  by  the  use  of  caloniel,  nauseating 
closes  of  emetic  tartar,  epispaslics,  fomentation  of  the  extremi- 
ties and  the  lungs,  in  the  form  of  vapour,  has  been  generally  pur- 
sued, and  in  some  instances  with  success.  It  is,  however,  to  be 
regretted,  that  notwithstanding  every  exertion,  a  very  consider- 
able number  of  cases  have  put  on  formidable  symptoms  in  a  few  - 
hours,  such  as  rattling  in  the  throat,  a  greatly  altered  counte- 
nance, and,  fin  -Uy,  have  terminated  in  death,  in  the  course  of 
one  day. 

"  Upon  laying  open  the  chesf  of  some  who  died  under  thj«^ 
form  of  disease,  congestions,  inflammation,  and  adhesions  have 
presented  themselves. 

"  The'above  cases,  when  compared  with  the  sthenic  form  of 
the  disease,  so  fur  as  my  observation  extends,  have  appeared 
only,  in  the  proportion  of  one  to  fifty.  This  epidemic,  in  its 
sthenic  form,  is  not  always  a  pneumonia.  The  fever  has  some- 
times appeared  without  any  local  affection,  under  the  type  of 
SYNocHA.  In  a  few  instances,  the  inflammation  has  attacked 
the  brain  and  its  meninges,  producing  pheenitib.  Inflamma- 
tion followed  with  suppuration  in  the  throat,  and  frontal  sinuses 
are  varieties  of  the  disease.     Distinctions,  however,  like  these^ 


'ii, 


nf 


■■! 


w 


;}2 


MKDICAL  HKETCHEB. 


fi 


are  of  little  practical  utility,  ns  local  inflammations  arc  invi»< 
riably  rcmQvt*<l  hy  tli«'  •'«m«  couiue  of  rt'mi'ilirs.  The  only 
practical  (UstinctionB  found  necr8Hary,  an>  of  ilH  Hcvrral  stages, 
which  present  themntlves  in  the  onler  of  coltl,  hot,  and  low 
stage. 

"  The  sthenic  form  of  this  disease,  in  ushered  in  by  a  cold 
ftnd  shivering  fit,  rather  remarkable  in  force  and  duration,  which, 
if  followed  by  increased  hent,  frpquency  and  strength  of  pulse, 
pain  in  the  side,  ditlicuit  respiration,  cough  and  expectoration, 
for  the  most  part  streaked  with  blood,  a  more  or  less  violent 
form  of  the  disease  may  be  expected. 

**  The  first  intention  is  to  remove  the  cold  stage ;  this  ts  ef- 
fected by  bathing  the  fet-l  in  warm  water,  by  [ilacing  the  patient 
in  bed,'  and  by  the  freipient  nH«;'of  vinegar  whey  for  drink.  This 
last  is  a  simple,  safe,  but  jiowerful  sudorific,  producing  its  effects 
>vithout  danger  from  its  stimulating  (|iiality.  These  means 
properly  applied,  shorten  the  duration  of  the  cold  stage,  of 
course,  lessen  the  hot  and  febrile  stage,  which  succeeds ;  and 
mitigate  inflammation  and  pain  wherever  seated.  Stimulants, 
especially  astringents,  as  the  patient's  life  is  endangered  there- 
by, should  here  be  avoided.  These  last,  when  em|)loyed  in  any 
considerable  degree,  increase  inflammation  and  render  the  ef- 
fects of  suitable  remedies  uncertain.  As  soon  as  the  cold  stage 
is  removed,  and  re-action  upon  the  surface  takes  place,  accom- 
panied with  beat  higher  in  degree  than  natural — flushed  coun- 
tenance~hardno8B,  fullness,  and  frequency  of  the  pulse — cough, 
difficulty  of  respiration — pain  in  the  head  or  side — or  even  when 
the  disease  shews  itself  only  by  an  increase  of  arterial  action, 
immediate  recourse  must  be  had  to  the  hfncet.  The  bleeding 
must  be  repeated  ;[^ro re  nafa.  After  venesection,  should  there 
foe  much  heat,  sul|)hate  of  soda,  (glaubers  salts)  may  be  admin- 
istered for  a  cathartic ;  after  which,  calomel  may  be  employed 
either  as  a  purgative,  or  an  alterative,  aa  the  case  indicates, 
Vf'iih  antimonials  in  nauseating  doa(>^.  Full  vomits  s^^ould  not 
be  given  until  proper  evacuations  have  been  made.  Puking, 
previous  to  any  evacuation,  while  the  vessels  are  distended,  and 
hignly   excited,  may  be   productive  of  fatal   consequences,  by 


CAMPAIGN  OF  18ia. 


3'i 


£U|>(urinK  (he  hloml  veMels  of  (he  brain  or  lung*.  Nitre,  crenm 
(artur,  demulcent  drinks,  and  diluenti  should  not  be  overlooked 
in  this  stage  o(  the  disease. 

**  When  expectoration  is  difficult,  and  the  lungs  loaded  with 
viscid  pidegm,  the  steams  oC  equal  parts  of  vinegar  and  water 
may  lie  inhaled  with  atl vantage.  ■ 

"  As  soon  as  the  violence  of  inflammation  is,  in  some  meas- 
ure abated,  epispastics  should  he  applied  to  the  |/aiti<>i|  pitrt. 
These  it  may  be  necessary  to  repeat,  as  the  nature  of  the  case 
may  require.  If  we  can  j)lace  any  reliance  upon  our  own  knowl- 
edge, or  have  the  least  confidence  in  medical  science,  it  must  b» 
conceded  that  this  form  of  epidemic  is  of  an  inflammatory  char- 
acter, requiring  depletion  and  the  antiphlogistic  treatment  for 
its  cure.  In  this  state,  we  have  not  been  governed  in  the  em- 
ployment of  the  lancet,  wholly  by  the  pulse,  which,  in  some  in- 
stances, is  rendered  small  by  the  obstruction  of  the  capillary 
circulation,  by  congestions,  and  general  torpor.  When  a  reso- 
lution of  the  inflammation  is  not  obtained  by  the  employment 
of  the  above  means,  the  disease  terminates  fatally,  io  eight  or 
nine  days.  '        * 

**  The  sinking  stage  of  the  disease  is  known  by  the  smallness 
of  the  pulse,  coldneo.a  of  the  extremities,  dark  or  shining  a\y- 
pearance  of  the  tongue,  extreme  debility,  with  some  degree  of 
delirium,  and  subsultus  tehdinum.  Here  the  patient  should  b« 
supported  with  wine  whey,  wine  and  water,  &c.  carefully  avoid- 
ing the  extremes  of  too  high,  or  too  low  excitement. 

''  An  over  proportion  of  excitement  will  increase  the  local  af- 
fection, which  is  supposed  still  to  exist  in  a  degree,  wliile  the 
want  of  it  will  leave  the  patient  to  languish,  and  sink  under  a 
general  debility.  Calomel,  in  small  doses,  so  as  to  produce 
some  degree  of  ptyalism,  gentle  emetics  of  ipecacuanha,  epispas- 
tics, laudanum  and  eccoprotics,  properly  timed  prove  serviceable 
in  this  stage  and  are,  in  a  great  proportion  of  cases,  attended 
"with  success.  In  the  cure  of  this  disease,  much  depends  on 
judiciously  timing  the  remedies. 

"  This  disease  has  prevailed  in  camp  among  the  soldiers,  and 
in  our  towns  and  villages  ajnong  citizens  under  similar  symp- 


f? 


n 


n 
■I 


H 


MEDICAL  SKETCHES. 


' 


'I5 


toms ;  and  it  is  a  well  known  fact,  that  more  of  the  latter,  tu 
proportion  to  the  nuinl)er  sick  in  this  vicinity,  have  fallen  vie* 
tims  to  this  disease  than  the  former."  .      *         . 

Jaundice  was  a  common  complaint,  during  the  convalescent 
gtate  of  this  epidemic.  The  tunica  adnata  of  the  eyes,  and  the 
skin  were  yellow ;  even  where  calomel  had  been  employed, 
during  the  course  of  (he  disease.  Its  continuance  in  small  dos- 
es, was  experienced  beneficial ;'  as  were  emetics  of  ipecacuanha,, 
occasionally  repealed.  Obstructions  in  the  ductus  contmunis 
choledocus,  were  (he  cause  of  this  regurgitation  of  bile ;  which 
exhibited  itself  throughout  the  lymphatic  vessels,  upon  the  su^ 
face.  This  is  one  evidence,  among  others,  which  may  be  ad- 
duced, that  during  the  disease,  there  was  a  want,  instead  of  re- 
dundance of  bile  in  the  intestinal  tube.  The  yellowness  did 
not  super\  ene,  until  a  resolution  of  fever  was  elfected  ;  and  the 
liver  with  the  other  secretory  organs  resumed  its  proper  office. 
In  constqueuce  of  concretions,  or  inspissat'ons,  which  existed 
in  the  common  biliary  duct,  the  cause  of  the  disease,  the  bile 
was  refused  a  passage  to  the  duodenum ;  and  accumulating 
in  itj  proper  reservoir,  was  reverted  into  the  general  circula- 
tion ;  whence,  was  absorbed  into  the  lymphatics.  This  seconda- 
ry complaint,  readily  yielded  to  remedies,  commonly  employed 
in  this  disease.  The  most  efficient  of  which,  were  emetics  of 
ipecacuanha. 

Jaundice  is  a  symtomatic  disease,  the  eflect  of  concretions, 
or  canculi  lodged  or  formed  in  the  common  biliary  duct.  The 
bile  which  shews  itself  upon  the  surface,  is  not  absorbed  into  the 
lymphatics  from  the  intestines.  During  the  yellowness,  the  fae- 
cal evacuations  are  generally  white  or  clay-coloured. 

Cases  of  disease  occur,  where  the  intestinal  evacuations  are 
dark,  brown,  or  greenish,  or  these  combined.  These  appear- 
ances accompany  indigestion,  and  deficient  secretion  of  gastric 
and  intestinal  liquors,  as  in  febrile  diseases.  These  morbid 
evacuations  have  been  su[)posed  to  be  vitiated  bile ;  whereas, 
thejT  exist  where  there  is  deficiency  of  this  fluid.  When  there 
are  high  grades  of  febrils  disease,  all  tlie  secretory  glands  are 
deranged,  and  cease  to  perform  their  offices,  and  beeome  torpid. 


CAMPAIGN  OF  1812. 


36 


One  of  the  r-ost  important,  in  the  economy  of  the  living  body, 
ig  the  liver.  A  deficiency  of  bile,  is  not  only  a  symptom  of  dig- 
eased  action,  but  becomes  also,  a  concomitant  cause  of  fever. 
Whenever  the  intestinal  evacuations,  under  this  state  of  dis- 
ease, exhibit  a  shew  of  bile,  a  resolution  of  the  disease  may  be 
expected. 

Hemorrhagia  from  the  intestines  indicates  a  torpid  stale  of 
the  liver,  when  the  blood  passes  from  that  viscus,  without  resist- 
ance. It  occurs  sometimes,  in  the  last  stage  of  typhous  fever ; 
wherein,  from  one  to  four  pounds  of  blood  have  been  evacuated 
in  forty  eight  hours.  From  two  to  four  grains  of  acetite  of  lead, 
with  one  grain  of  opium,  have  been  experienced  an  excellent 
remedy.  Then  a  blister,  on  the  region  of  the  liver ;  bark  and 
wine.  '  '  ""      !   -       ' 

The  liver  of  inebriates  becomes  torpid.  Having  lost  its  se- 
creting powers,  the  blood  sometimes  pours  in  torrents,  through 
the  ductus  communis  cholcdocus  into  the  duodenum ;  thence,  evac- 
uated per  anxim.  In  these  cases,  hemorrhagia  may  prove  saluta- 
ry, by  obviating  a  more  formidable  disease — apoplexy.  An 
enebriate,  after  large  potations  of  ardent  spirits,  was  found  apo- 
plectic in  his  bed.  Intestinal  hemorrhagia  soon  succeeded, 
and  removed  the  effects  of  the  spiritous  excitement  on  the 
brain. 

Pf  the  causes  of  diseases,  as  they  appeared  in  the  army,  the 
following  'I'bservations  suggest  themselves.  It  c;,.:iot  be  too 
often  repeated,  an  intemperate  use  of  ardeui  spirits,  is  among  the 
exciting  causes  of  violent  disease.  A  disease,  which  might 
have  been  mild,  generated  only  by  unavoidable  causes,  became 
severe,  by  alcoholic  excitement.  A  man  in  a  convalescent 
state  from  the  epidemic  of  the  winter  left  the  hospital  without 
permission,  and  returned  to  his  quarters,  where  he  drank  half  a 
pint  of  whiskey.  A  recurrence  of  fever  was  excited,  with  the 
most  formidable  symptoms.  He  was  sent  back  to  the  hospital, 
where  in  twelve  hours  he  died — a  victim  to  folly  and  impru- 
dence. 

Immoderate  potations  of  spirits,  by  weakening  the  sensorial 
powers,  and  inducing  general  debility,  become  a  predisponent 


III 


'% 


30 


MEDICAL  SKETCHED 


t 


MS;.! 


-  II 


cause  of  disease.  They  are  likewise  an  exciting  cause,  at  the 
time  they  are  taken  into  the  stomach,  by  excess  of  stimulation  ] 
and  vhen  superadded  to  remote  atmospheric,  and  more  ohviouv 
cjiuses,  induce,  where  there  is  morbid  action,  a  most  violent 
disease.  Not  a  few,  who  were  subjected  to  the  epidemic  of  the 
winter  1812-13,  fell  victims  to  that  disease,  from  this  exciting 
cause. 

An  irregularity  must  not  be  passed  by  without  notice.  It 
was  observed  at  times  during  the  war,  that  non-commissioned 
officers,  whose  duty  it  was  to  issue  the  ration  of  spirits  to  the 
men,  performed  it  by  ol)liging  them  to  drink  the  whole  at  once, 
rather  than  submit  to  the  more  slow  task  of  pouring  it  into  their 
santeens.  This  was  performed  in  the  morning  before  breakfast. 
This  disorderly  practice  was  not  countenanced  by  officers,  who 
regarded  the  health  of  the  men  under  their  immediate  command; 
oonsequently,  the  practice  was  not  general. 

My  opinion  long  has  been,  that  ardent  spirits  are  an  unneces- 
sary part  of  a  ration.  This  allowance,  as  a  part  of  a  ration,  is 
■ot  however,  the  evil  which  demands  a  remedy.  It  is  the  abuse 
of  spirits.  Sutlers  unrestrained,  as  they  frequently  are,  destroy 
more  lives  by  these  liquors,  than  are  lost  by  other  causes  to 
which  soldiers  are  exposed  ;  and,  so  long  as  ardent  spirits  are 
permitted  to  be  publicly  sold  in  the  vicinity  of  a  cantonment, 
these  evils  cannot  be  remedied  by  any  restrictions,  under  which 
sutlers  may  be  placed.  A  soldier  habitually  intemperate,  is  al- 
ways industrious  to  procure  the  means  of  indulging  his  appetite. 
All  his  cunning  and  every  artifice  are  put  into  requisition  to 
obtain  the  inebriating  draught.  Reputation,  honour,  health, 
and  even  life  are  sacrificed  to  his  gratification. 

Examples  may  be  furnished  to  demonstrate,  that  ardent  spirits 
are  a  useless  [)art  of  a  soldier's  ration.  At  those  periods,  during 
the  revolutionary  w^ar,  when  the  army  received  no  pay  for  their 
services,  and  possessed  not  the  means  to  procure  spirits,  it  was 
healthy.  The  4th  Massachusetts  regiment  at  that  eventful 
period,  of  which  I  was  the  surgeon,  lost  in  three  years,  by  sick- 
ness, not  more  than  5  or  6  men.  It  was  at  a  time  when  the 
army  was  destitute  of  money.     During  the  winter  of  79, 80,  there 


il|ll  I 


CAMPAIGN  OP  1812. 


2t 


wns  only  one  occurrence  of  fever  in  the  regiment;  ami  that  was 
a  pneumonia  of  a  mild  form.  It  was  observable  the  last  war, 
from  l)eceml)er  181  I,  to  April  1815,  the  soldiers  at  Plattsburgh 
were  not  attacked  with  fevers  as  they  had  been  the  preced- 
ing winters.  The  troops,  during  this  period,  were  not  paid;  a 
fortunate  circumstance  to  the  army  ;  arising  from  a  want  of  funds. 
Tliis  embarrassment,  which  was  considered  a  national  calamity, 
proved  a  blessing  to  the  soldier.  When  he  is  found  poor  in 
money,  it  is  always  the  case  that  he  abouuils  in  health.  A  fact 
worth  recording  ! 

Deserters  from  the  British  army,  of  wliom  some  hundreds  came 
to  our  posts,  exhibited  marks  of  high  health;  while  those  of  our 
soldiers  were  pallid  and  emaciated.  The  tlitference  was  too 
obvious  to  have  escaped  the  observation  of  the  officers  of  the 
army.  It  led  me  to  seek  the  cause.  Upon  enquiry  it  was  learnt, 
that  spirits  were  no  part  of  the  ration  of  the  British  soldier;  that 
these  liquors  could  not  be  procured  in  the  upper  province  of  Can- 
ada for  money.  While,  in  addition  to  their  daily  rations,  our 
soldiers,  when  they  had  money  in  their  pockets,  had  free  access 
to  spirits  at  the  stores  of  the  sutlers.  Diseases  and  mortality 
generally,  but  not  necessarily,  followed  the  pay-masters  of  the 
army.  With  means  to  make  themselves  comfortable,  soldiers 
frequently  render  their  lives  wretched. 

It  may  be  esteemed  medical  heresy  by  some,  to  declare  it  is 
my  opinion,  that  ardent  spirits  should  not  be  used  as  a  common 
beverage,  diluted  or  not.  Habits  are  unconquerably  stubborn. 
Long  established  |)ropensities  will  not  yield  to  the  voice  of  rea- 
son. Temperance  is  one  of  the  pr.'icepts  inculcated  by  our  di- 
vine master;  and  the  doctrine  has  been  preached  by  his  disci- 
ples. Still,  with  all  the  heavy  denunciations  of  heaven  against 
the  sin  of  inebriation,  but  few  reform.  This  vice  ia  a  growing 
evil.  -^  ..>,.. 

The  time  was  when  ardent  spirits  were  not  known.  Then 
the  salubrious  fountains  of  water  were  resorted  to  by  the  healthy 
and  athletic  to  satiate  their  thirst.  The  early  productions  of 
the  still,  it  is  highly  probable,  were  employed  as  medicine. 
They  now  hold  a  distinguished  place  in  tlie  materia  mcdica,  ami 

6 


m 


m\ 


;i.i. 


1.' 
1  ii 


%  • 

r   I 
Jsi   i 


m 


II! 


38 


MEDICAL  SKETCHES. 


!'., 


i'l 


i  !! 

i  I! 
'1i 


were  they  confined  to  the  store-houses  of  druggists,  and  the  dis- 
pensaries of  physicians,  the  sphere  or  tlieir  utility  would  be  vast- 
ly enlarged.  ■ 

Cleanliness  is  the  lire  of  an  army ;  while  filth  and  dirt  are 
among  its  disease-generating  causes.  The  observance  of  clean- 
liness in  domestic  life  is  of  the  highest  ini)>ortance  to  secure  the 
body  in  health.  is  no  less  valuable  as  a  menu  of  snpitorting 
the  strength  and  efficient  force  of  an  army  in  actual  service. 
Filth  and  dirt  become  more  active  destroyers  of  life  when  they 
cooperate  with  pestilential  states  of  atmosfihere,  or  insalubrious 
gasses,  the  production  of  unhealthy  climates  or  noxious  situa- 
tions. Cleanliness  should  be  enforced  U[ion  soldiers  with  most 
rigid  laws.  That  code  under  the  Jewish  dispensation,  enjoining 
ablutions  and  purifications,  was  obeyed  as  a  religious  rite ;  it 
has  been  quoted  as  a  system  well  adapted  to  a  cam|i.  It  has 
been  observed,  that  those  regiments  which  have  been  subjected 
to  rigid  discipline,  s  d  where  cleanliness  has  been  strongly  en- 
forced, have  enjoyed  higher  states  of  health  than  those  who  have 
been  inattentive  to  this  duty.  A  man  cannot  be  made  a  good 
soldier  unless  he  is  made  to  keep  himself  clean.  This  is  better 
effected  by  infusing  into  hib  soul  a  pride  for  neatness  of  dress 
and  appearance,  than  by  punishment  for  neglect ;  though  the 
last  is  sometimes  necessary.  Good  discipline  is  better  maintain- 
ed among  a  body  of  men  by  what  is  termed  Cesprit  du  corps,  than 
by  austerity  and  severity.  A  good  soldier  will  be  ambitious  to 
execute  his  duty  with  fidelity  ;  he  will  feel  that  he  has  not  de- 
graded himself  by  assuming  the  profession  of  arms.  To  form 
within  him  this  state  of  mind,  he  should  be  taught  to  obey  the 
civil  laws  of  his  country,  and  to  respect  the  interests  of  the  citi- 
zen ;  and  to  violate  either  is  not  only  criminal,  but  extremely 
dishonorable.  He  should  realize,  that  his  country  beholds  him 
as  an  honorable  protector  of  its  rights,  and  ajxist  avenger  of  its 


wrongs. 


A  treatment,  which  is  due  to  a  rational  being,  not  such  as  a 
slave  or  a  servile  subject  of  a  tyrant  receives,  will  impress  upon 
a  soldier  exalted  sentiments  of  honor  and  justice,  so  necessary 
to  secure  his  warmest  attachment,  and  faithful  services  to  the 
state. 


CAMPAIGN  OP  1812. 


30 


The  refitiments  of  heavy  and  light  nrtillery  suffered  less  by  dis- 
ease (lurinj:  tlie  war,  than  any  other  regiments  on  the  northern 
frontiers.  It  is  unnecessary  to  ohstrve,  these  regiments  have 
been  always  subject  to  correct  discipline;  and  their  better  health 
may  be  much  imputed  to  cleanliness.  Their  quarters  and  en- 
campments were  generally  in  the  best  state;  the  men  were, 
mostly,  neat  and  clean  in  their  dress  and  appearance. 

Thero  was  one  regiment  on  the  frontiers,  which  at  one  time 
counted  nine  hundred  strong,  but  was  reduced  by  a  total  want 
of  good  police  to  less  than  two  hundred  fit  for  duty  in  the  course 
of  two  months.  This  regiment,  in  its  appearance,  was  at  that 
time  dirty  in  the  extreme.  To  save  the  remnant,  if  possible, 
General  Dearborn  found  it  necessary  to  place  it  under  the  com- 
mand of  Colonel  Miller  (now  General)  by  annexing  it  to  his 
regiment.  At  one  period  more  than  three  hundred  and  forty  of 
this  reginze'  t  were  iu  hospitals ;  in  addition  to  these,  a  large 
number  were  reported  sick  in  camp.  At  the  close  of  the  war, 
this  regiment  had  established  a  high  reputation.  Its  good  disci- 
pline and  bravery,  were  excelled  by  none. 

Health  is  impaired,  and  fatal  diseases  are  the  consequence  of 
unequal  and  variable  excitements  in  the  system,  produced  by 
any  cause ;  either  acting  as  a  preternatural  stimulus  on  the  stom- 
ach, the  skin,  or  the  lungs.  Such  are  lai^e  potations  of  spirits. 
Such  are  accumulations  of  filth  and  dirt,  when  in  contact  with 
the  skin.  Such  are  those  emanations  which  proceed  from  sub- 
stances in  a  state  of  putrefaction,  when  received  into  the  lungs. 
Under  the  above  circumstances,  cold,  in  an  especial  manner, 
produces  its  deleterious  effects. 

Unequal  excitements  in  the  animal  system  are  induced  by 
transition  of  seasons,  as  well  as  weather.  These  transitions, 
with  the  cooperation  of  pestilential  states  of  atmosphere  and  oth- 
er causes  better  understood,  produce  diseased  actions,  destroy 
health,  and  accelerate  death.  These  fatal  evils,  the  cause  of  a 
part  of  which  being  cold,  mF^y  in  some  degree  be  obviated  by 
warm  cloathing. 

More  especially  the  sudden  changes  of  weather  to  which  sol- 
diers are  unavoidably  exposed  in  the  field,  and  the  formidable 


ti: 


40 


MEDICAL  SKETCHES. 


I 

J 


\  1 '  ll 


h\f 


!■; 


1,1 


iliseases  uhicli  are  the  consequence,  might  he  nn  inducement  lu 
government,  as  it  is  for  the  highest  interest  of  the  nation,  to 
guard  the  health  of  the  army,  and  preserve  the  services  of  the 
men  in  the  field,  to  furnish  them  annually  with  a  pair  of  woollen 
shirts.  A  garment  of  wnoi  next  the  skin  would  secure  the  body 
from  cold  more  cfl'ectually  than  three  garmmts  of  the  same  thick- 
ness worn  over  linen.  Wool  is  not  a  good  conductor  of  heat ; 
consequently,  under  all  circumstances  of  cold  and  wet,  it  retains 
the  natural  heat  of  the  body. 

The  additional  expense  of  woollen  shirts  to  the  nation  w ould 
i)e  but  small,  which  would  be  remunerated  by  this  imjjrovement; 
not  only  in  the  saving  of  bounties  paid  to  necessary  recruits  to 
supply  the  loss  occasioned  by  sickness  and  its  consequences  ; 
but  more  especially  in  obviating  the  wounds  too  frequently  in- 
ilicted  by  death  of  a  friend  or  connection.  • 

The  substance  of  the  last  observation  was  jiublished  in  the 
MEnicAL  REPCsiTony,  at  New-York,  in  connection  with  com- 
munications upon  the  winter  epidemic  of  1812,  13.  The  senti- 
ments herein  adduced  had  been  previously  communicated  to  of- 
ficers of  high  grade  in  ^the  army.  What  influence  the  sugges- 
tion had  at  that  time  to  effect  the  proposed  improvement,  is  to 
me  unknown.  The  winter  following,  however,  with  much  grat- 
ification, it  was  understood  that  a  pair  of  woollen  shirts,  in  con- 
formity to  the  proposition,  was  made  by  government  a  part  of 
cloathing  allowed  the  soldier.  This  garment  was  worn  by  offi- 
cers also,  even  during  the  summer  months,  while  in  tents. 

Having  experienced  from  woollen  garments  next  the  skin  the 
greatest  benefits,  while  exposed  in  my  tent  on  the  northern  fron- 
tiers, during  every  canT|iaign,  and  witnessed  its  salutary  effects 
iu  others  while  m  the  field,  an  additional  improvement  is  urged, 
for  the  consideration  of  government.  That  the  soldiers  destined 
to  perform  duty  on  {lie  northern  and  western  frontiers  be  entire- 
ly furnished  with  woollen  garme.its.  There  are  a  few  days  on- 
ly, during  a  campaign,  that  men  Avould  be  incommoded  by  the 
increased  heat  of  woollen  garments;  then  only  a  few  hours  in 
1  he  day. 

Men  in  tents  during  the  hot  seasons  experience  little  ineon 


f 


CAMPAIGN  OP  1812. 


41 


I, 


venience  from  those  garmenls  of  wool  next  the  skin,  wliich  is 
overbalanced  by  their  advantageous  effects,  while  exposed  to 
cold  and  rain  on  necessary  duty.  Checks  of  perspiration,  or  an 
al)straction  of  heat  from  tl>e  surfnceof  the  body,  cooperate  with 
a  variety  of  other  causes  to  produce  diseases,  which  these  gar- 
ments would  obviate.  Woollen  garmenls  are  most  important 
and  necessary  for  men  employed  on  expeditions,  in  the  wilder- 
derness,  when  at  war  wilh  hostile  savages;  where,  destitute  of 
tenis,  they  are  unavoidably  exposed  to  weather,  both  wet  and 
cold.  Clothed  in  wool,  during  all  seasons,  soldiers  would  enjoy 
higher  degrees  of  health.  We  should  behold  them  more  hardy 
and  robust,  enduring  the  severest  hardships,  the  most  fatiguing 
marches,  and  the  inclemency  of  seasons,  without  attacks  of 
disease. 

If  an  unequal  excitement  exists  in  the  system  during  a  state 
of  fever,  it  is  most  evident  that  cold,  or  an  abstraction  of  heat 
from  the  surface,  is  among  the  most  hurtful  agents. 

It  is  also  evident,  that  while  the  surface  of  the  body  is  under 
a  state  of  exhaustion  by  cold,  an  excess  of  stimulants  taken  into 
the  stomach  does  not  diminish,  butincreases  (he  dangerous  state. 

The  deleterious  effects  produced  by  the  above  hurtful  agents 
are  proportionate  to  the  degrees  of  exhaustion  on  the  surface,  and 
the  exciting  powers  received  into  the  stomach. 

Hence  ardent  spirits  become  more  hurtful  agents  during  the 
severe  frosts  of  winter,  than  during  the  heat  of  summer. 

The  two  first  hurtful  agents  in  conjunction  during  winter,  in- 
duce the  most  dangerous  forms  of  our  winter  epidemics. 

These  epidemics,  therefore,  are  most  fatal  to  men  whose  vital 
energies  have  been  most  frequently  exhausted  ;  they  are  accom- 
panied by  engorgement  of  some  viscus  important  to  life,  and  fee- 
ble action  of  the  arteries  at  their  extremities.  ' 

This  state  is  sometimes  attended  with  a  deficient  venous  ah- 
sorption  ;  hence  the  spots  which  are  seen  in  the  skin. 

When  robust  men,  who  have  not  often  been  exposed  to  those 
hurtful  powers,  become  subjected  to  them,  a  dangerous  fever  en- 
sues with  strong  arterial  action.  During  its  violence,  either  the 
brain  or  the  lungs  are  endangered  by  its  excess. 


!  H 
hi 


^rn 


r 

1     ■ 

' 

; 

<' 

i 

I 

iHi'    ' 

1 

m 


'/ 


ii( 


■  ! 


i^> 


4f 


MEDICAL  SKETCHES. 


\h 


When  hurtful  agents  operate  upon  a  body  exposed  to  them 
during  the  heat  of  summer,  the  excess  of  unequal  excitements  is 
not  so  great;  becHuse  the  degrees  of  hurtful  powers  are  rela- 
tively less  than  during  winter,  yet  sufficiently  great  to  induce  a 
dangerous  fever. 

This  state  however  does  not  necessarily  precipitate  the  boily 
to  a  most  sudden  death ;  l>ut  a  destruction  of  an  organ  important 
to  life  slowly  progresses.  Although  death  does  not  immediately 
ensue,  yet  it  is  as  certain  ;  provided  the  diseased  state  is  left  to 
its  own  operation. 

Of  this  description  are  the  fevers  of  summer  and  autumn. 
These  last  states  of  fever,  however,  are  under  the  influence  of 
additional  hurtful  agents,  which  depend  on  local  causes  for  their 
existence  ;  such  as  marsh  miasmata,  and  putrid  effluvia. 

These  last  described  states  of  fever  have  for  causes  other  co- 
operating hurtful  agents;  as  bad  nutriment,  excessive  fatigues, 
long  watchings,  and  mental  depressions,  &;c. 

The  hurtful  agents  of  winter  above  mentioned  exhibit  their 
effects  immediately  upon  the  lungs  or  the  brain,  mediately  upon 
the  muscular  system  by  pains  in  greater  or  lesser  degrees,  pro- 
portionate to  the  powers  of  tho£>e  agents. 

The  above  agents  during  summer  and  autumn,  exhibit  their 
first  deleterious  effects  most  frequently  upon  the  intestines;  their 
second  throughout  the  system  by  association. 

In  all  states  of  fever  the  first  indication  is  to  remove  the  hurtful 
agents.  The  cold  upon  the  surface  and  extremities  is  obviated 
by  artificial  heat ;  various  modes  of  applying  heat  have  been 
employed.  Those  means,  by  which  heat  is  most  equally  diffu- 
sed, are  to  be  preferred. 

The  suitable  application  ^  icat,  in  the  cold  stage  of  fever,  is 
the  first  mean  to  be  employed  to  equalise  excitement. 

The  second  indication  is  to  obviate  the  tendency  to  death, 
the  effect  of  engorgement  by  evacuations ;  as  cautious  bleedings, 
in  cases  where  arterial  action  is  suppressed  at  the  extremities, 
and  by  cathartics ;  or  bold  bleedings,  where  the  arteries  act  with 
force  at  their  extremities ;  and  by  drastic  purges.  These  are 
the  second  means  employed  to  equalise  excitement. 


CAMPAIGN  OP  1812. 


43 


The  third  indication  is  to  remove  the  remains  of  unequal  ex< 
citement,  (he  consequence  o(  hurtful  agents,  by  means  less  pow* 
erful  than  those  above  mentioned,  but  Avhich  are  adapted  to  par- 
ticular affections,  the  efifects  of  diseased  action,  the  consequence 
of  association  of  parts. 

These  are  opium,  blisters,  emetics,  eccoprotics,  antimonials, 
and  calomel  in  small  doses.  These  are  the  third  means  em- 
ployed to  equalise  excitement  in  the  system. 

The  fourth  indication  is  to  obviate  debility,  the  effects  of  the 
hurtful  agents ;  or  of  those  means,  which  are  necessarily  em- 
ployed to  counteract  the  tendency  to  death. 

These  are  either  natural  or  artificial  stimulants.  The  first  if 
nutriment,  whioh  is  permiinent.  The  last  are  vinous  liquors,  or 
spirits,  which  are  diffusible  and  transient. 

These  stimulants  require  caution  in  their  administration ;  and 
are  to  be  adapted  to  the  state  of  debility,  or  excitability  of  the 
system. 

The  following  extracts  of  reports  will  shew  the  state  of  the 
hospitals,  under  my  direction,  during  the  winter  1812-13. 

"  The  hospital  department  at  Plattsburgh  has  not  been  des- 
titute of  the  common  supplies,  which  are  usually  furnished  the 
sick  of  an  army ;  while  every  requisition,  made  for  hospital 
stores,  has  been  promptly  answered.  During  the  month  of 
November,  ample  supplies  of  stores,  as  wine,  spirits,  sugar, 
molasses,  rice,  tea,  and  chocolate,  were  ordered  by  General 
Dearborn,  to  be  forwarded  to  Plattsburgh,  under  the  charge 
of  Doctor  Wilson,  hospital  surgeon's  mate.  In  December,  an 
additional  quantity  was,  by  orders,  directed  to  the  same  post, 
and  Burlington.  Upon  an  interview  with  Doctor  Wilson, 
when  inspecting  the  hospital  at  Plattsburgh,  in  the  month  of  Jan- 
uary 1813,  who  then  had  the  charge  of  the  hospital  at  that  post; 
information  was  given,  that  the  supplies  of  November  had  not 
been  expended.  The  hospital  under  his  direction  is  found  in 
the  best  state.  The  beds  are  amply  furnished,  the  wards  clean, 
the  kitchen  neat.  No  less  credit  is  due  to  Doctor  Lovell,  sur- 
geon of  the  9th  regiment,  under  whose  charge  the  hospital  at 
Burlington  is  placed,  on  account  of  its  good  condition,  and 
the  unremitted  attention  bestowed  ou  the  sick." 


1 1 


M 


44 


MEDICAL  SKETCHEH. 


i^ 


i|i 


"  The  huBpitui  at  Greuubtisli  h  in  goud  unler,   and  tlie  pa 
iienla  comrortable." 

At  this  period,  in  an  official  report,  it  waH  also  stated,  "  that 
no  army  was  ever  better  supplied,  with  hoHpitai  storeu,  tliaii 
timt  on  the  frontiers."  Therefore,  a  want  of  necessaries 
could  not  justly  have  been  ussii^ned  a  cause  of  the  great 
mortality,  ns  was  rumored  at  a  distance  from  the  army.  It 
might  have  been  expected  at  such  a  period,  that  the  number  of 
deaths  would  have  been  vastly  exaggerated ;  but,  when  It  was 
most  evident,  that  erroneous  reports  were  imposed  upon  the  pub- 
lic, with  design  to  render  government  and  its  otticers  odious, 
to  cITect  the  purposes  of  a  party,  the  evil  retpiired  a  remedy. 

It  was  well  known  at  the  commencement  of  the  war,  that 
Uiere  were  men  in  service  on  the  frontiers,  who  exerted  their 
talents  to  render  the  army  disreputable ;  to  create  discontent- 
Int:<.^  and  encourage  insubordination  among  the  soldiers.  The 
officers  of  the  regular  army  were  not  implicated  in  this  charge. 
The  following  is  a  correct  statement — a  detachment  of  the  New- 
York  militia  was  not  furnished  with  hospital  stores,  agreeably 
to  a  requisition  of  its  surgeon.  In  this  case,  the  officer  com- 
manding  the  regiment  refused  to  conform  to  a  regulation  adopt- 
ed for  the  government  of  the  hospital  de[)artment ;  which  was, 
that  requisitions  for  stores  should  have  the  signature  of  the  com- 
mandants of  corps.  The  surgeon  of  this  regiment  of  militia,  in 
a  letter  addressed  to  myself,  feelingly,  and  politely  regretted  the 
"  untoward  disposition,"  of  his  commanding  officer,  which  pre- . 
vented  him  such  supplies  as  he  required.  For  the  want  of  these, 
no  one  could  have  been  made  accountable,  except  his  perverse 
and  obstinate  commanding  officer. 

The  above  recited  transaction  gave  rise  to  a  report,  as  was 
intended,  injurious  in  its  consequences  to  the  public  service. 
Exaggerated  accounts  of  deaths  in  the  army,  with  a  similar 
view,  were  crowded  into  the  public  papers  ;  when  the  mortality 
among  citizens  was  scarcely  noticed  by  them.  From  these 
sources,  it  \t  highly  probable,  that  Doctor  Gallup  obtained  his 
information,  respecting  the  ravages  of  the  pneumonic  epidemic,  at 
Burlington.    (See  note  d.) 


t  I  ■• 


:^!l 


CAMPAIGN  OP  1812. 


4ft 


Tiie  Kr^atrst  mortality  in  the  army  was  in  tjie  month  of  De- 
eemlx^r,  IB12;  at  a  period  when  allmulants  were  employed  na 
rardicine.  The  evacimtina;  niul  antiphlogistic  practice  was 
adopted  the  firsi  week  in  January ;  during  which  month,  mor- 
tality had  neiirly  censed,  as  the  disease  was  generally  under  the 
control  of  remedies,  although  the  number  on  the  sick  reports 
was  not  diminished.  This  lust  fact  was  evident,  by  the  month- 
ly regimental  reports.  The  numlier  of  deaths  reported  in  the 
2Ut  regiment,  for  December,  1812,  was  thirty -three.  The 
number  reported  in  the  same  regiment,  for  January,  1813,  was 
three.  If  we  take  the  re|)ort8  of  the  21  st  regiment,  as  the  ratio 
for  Decemlier  and  January,  the  deaths  were  as  eleven  to  one. 
Then  as  the  whole  number  of  deaths,  agreeably  to  oflicial  re- 
ports, in  the  month  of  Deceml>er  at  Burlington,  was  one  hund- 
red and  lifty ;  so  in  the  month  of  January,  the  deaths  did  not 
exceed  fourteen.  It  is  a  truth,  that  in  a  ho8|)ita1,  which  coi»- 
taincd  one  hundred  men,  there  was  not  one  death  the  two  last 
weeks  in  January.  The  reports  of  deaths  were  less  in  Februa- 
ry, than  the  preceding  month ;  three  only  died  in  the  same  hos- 
pital, during  the  last  month.  During  the  mouth  of  March,  there 
were  but  few  cases  of  the  epidemic. 

From  the  preceding  statements,  which  are  the  most  correct, 
which  can  at  this  time  be  given,  it  is  evident,  that  the  number 
of  deaths  from  the  indt  week  in  November,  1812,  to  the  last  of 
February,  ISlit,  at  Burlington,  did  not  exceed  two  hundred.  It 
has  been  estimated,  that  during  the  above  period,  about  two 
hundred  died  at  Plattsburgh.  From  a  correct  report,  made  at 
Greenbush,  of  deaths  from  the  first  of  August,  1812,  to  the 
last  of  February,  1813,  the  whole  number  was  eighty-nine. 

A  general  account  of  the  weather,  from  July  to  November 
1812,  has  been  noticed.  December  was  severely  cold.  The 
second  week  in  January  1813,  there  was  rain  and  thaw.  From 
the  middle  of  January,  to  the  middle  of  February,  the  weather, 
on  the  border  of  Lake  Champlain,  was  cold,  and  little  variable. 

The  order  in  which  the  several  forms  of  disease  supervened, 
during  the  campaign  1812,  is  as  follows:  Dysentery,  diarrhoea, 
and  fever,  in  the  month  of  July,  August,  and  September.    Dlarj 


^P'i 


v    > 


t    '; 


If    ' 


40 


MEDICAL  SKETCHED 


1/' 


rtiflsa  anil  pneumonia,  diarrhcca  and  rheumatalgia,  and  measles^ 
in  October  and  November.  Pneumonia  notha,  and  severe  pneu- 
monia, in  December  1812,  and  January  and  February  1813; 
-whicli  were  the  prevailing  winter  epidemioifc  •  • 


ill 


END  OF  CAMPAIGN  181!^ 


I      lit 


p*  t 


•  .' 


<.^v    .  •. 


CAMPAIGN  OP  1813. 


HAVING  iDspected  the  hoBpitnls  at  Plftttshurgh  niul  Bur; 
Kngton,  duty  made  it  requisite  for  me  to  retnrn  on  the  10th 
of  Pebruarj,  1813,  to  Greenbush,  where  the  direction  of  the  hogr 
pital  employed  most  of  my  time  the  remainder  of  that  month. 
The  sicic,  who  had  been  comf(>rtal)ly  accommodated  in  one  of 
the  common  barracks,  were  now  removed  to  the  new  hospital. 
The  regiment  of  dragoons,  under  the  command  of  Col.  Burns, 
and  a  detachment  of  light  artillery,  commanded  by  Major  (now 
Colonel)  EusTis,  had  taken  quarlerd  for  the  winter  at  this  cau^ 
tonment. 

The  soldiers  of  these  regiments,  particularly  those  of  the 
light  artillery,  had  severely  suffered  by  the  epidemic  pneumonia. 
After  my  return  from  Lake  Champlain,  there  were  many  severe 
cases  of  the  disease  at  this  post.  The  surgeon,  under  whose 
charge  the  hospital  had  been  placed,  during  my  absence,  ex- 
posed himself  to  reprehension,  by  inattention  to  duty.  This 
was  supposed,  by  the  officers  of  light  artillery,  to  have  been  one 
cause  of  a  number  of  sudden  deaths  in  that  corps.  It  was  med- 
itated to  prefer  charges  against  the  delinquent.  These  were 
suppressed,  while  preparations  to  obey  orders,  from  the  Con»- 
niander  in  Chief  to  march,  absorbed  every  other  consideratioB 
of  minor  consequence. 

The  movement  of  tlie  troops  from  Greenljush,  at  this  season, 
March  2,  1813,  preceded  by  General  Dearborn  to  Sackett's 
Harbour,  on  Lake  Ontario,  indicated  that  active  operations 
would  commence  early  the  ensuing  campaign.  This  march,  a 
distance  of  nearly  two  hundred  miles,  wa«  accomplished  in  tlve 


ii  :'■ 


49 


MEDICAL  SKETCHES. 


1 


m 


':i     ' 


1    V  - 

^ 

1 

jl  : 

:. 

1. 

■ 

i 

: 

11 

, 

ill 

J 

1^: 

1 

^'i^ 

i'lil  ; 

and  six  days.  The  greatest  part  of  which  was  performed  dur- 
ing a  Btorm  of  snow,  or  weather  severely  cohl.  The  direction 
of  the  line  of  march  was  on  the  Mohawk  turnpilte. 

The  Mohawk  empties  into  the  Hudson,  six  miles  north  of 
Aibaiiv,  lititween  the  towns  of  Troy  and  Waterford,  by  several 
mouths.  Two  miles  above  these  outhMs  is  Calioos  falls.  These 
falls  are  seen  at  the  distance  of  two  or  three  miles,  and  combin- 
ed with  the  surrounding  hills,  the  adjacent  Hats,  and  the  small 
villages  on  the  banks  of  th«  river,  with  its  divided  branches, 
winding  their  courses  between  little  islands  at  its  mouth,  exhi- 
bit a  landscape  pleasingly  picture  sque.  A  nearer  view  of  the 
uninterrupted  sheet  of  water,  two  hundred  yards  in  width,  fal- 
ling from  u  height  of  seventy  feet,  is  a  scene  truly  sublime. 
One  mile  below  the  falls,  the  river  is  passed  over  by  a  hand- 
some bridge. 

Schen  3Ctady,  an  incorporated  city,  is  situated  on  the  banks 
of  the  ^  ohawk,  twelve  miles  above  the  falls.  It  was,  original- 
ly, settled  by  the  Dutch  ;  and  is  one  of  the  most  ancient  towns 
in  the  state  of  New-York.  Its  early  inhabitants  severely  suffer- 
ed by  the  Indian  wars,  and  their  depredations.  The  town,  con- 
sisting of  sixty- three  houses,  was  destroyed  in  February  1(390, 
by  a  party  of  French  and  Indians  from  Canada.  This  was  a 
frontier  post,  until  the  conclusion  of  the  revolutionary  war. 
Since  which,  it  has  wonderfully  increased.  Its  population  in 
1810,  by  the  census,  was  5909.  The  great  turnpike,  from  Al- 
bany up  the  Mohawk,  passes  through  this  town,  and  here  cros- 
ses that  river,  over  a  fiuperb  wooden  bridge,  997  feet  in  length, 
roofed  over  throughout  its  extent.  The  lands  in  its  vicinity 
ai-e  nearly  level,  the  soil  rich.  On  the  west,  the  city  plat  is 
washed  by  the  Mol-awk ;  over  which  are  extensive  alluvial 
lands,  under  good  cuitivation.  On  the  east,  the  lands  are  sandy 
and  light  loam,  barrtn,  and  litl'e  cultivated  for  several  miles, 
covered  with  yellow  pines  of  diminished  growth.  The  city  is 
built  ou  streets,  regularly  laid  out  in  squares,  and  contains  be- 
tween five  and  six  hundred  houses  mostly  of  brick ;  three  edifi- 
ces for  the  College,  which  is  in  an  improving  state,  by  liberal 
public  and  private  endowments ;  from  its  position  and  increos- 


CAMPAIGN  OV  181fl. 


4» 


ing  importance,  it  will  become  within  a  few  years,  the  f^rst  lit- 
erary institution  in  the  United  States.  Here  are  four  houses 
for  divine  worship.  The  courts  for  the  county  are  held  at  this 
city. 

Boat  navigation  up  the  Mohawk  commences  here.  From 
this  place  to  Albany  is  a  portage  of  sixteen  miles,  occasioned 
by  the  Cahoos  falls,  which  intervene  between  the  Mohawk  and 
Hudson. 

With  the  aid  of  four  short  canals,  boat  navigation  up  this  riv- 
er is  continued  to  Wood-Creek,  through  Oneida  lake,  and  Os- 
wego river ;  a  distance  of  more  than  two  hundred  miles.  The 
canal  at  Little  Falls,  seventy -one  miles  west  from  Albany,  is 
one  mile  in  length  ;  upon  which  are  several  locks,  which  give  a 
rise  of  more  than  forty  feet.  The  canal,  which  connects  the 
upper  branch  of  the  Mohawk,  with  the  Ontario  at  Rome,  one 
hundred  and  eight  miles  N.  W.  from  Albany,  is  one  and  a  half 
mile  in  length,  with  a  lock  at  each  end.  The  lift  at  the  eastern 
is  ten  feet ;  that  at  the  western,  eight  feet.  At  Wood-Creek 
are  four  other  locks. 

As  we  ascend  the  Mohawk,  on  the  turnpike,  a  number  of 
creeks  are  passed ;  over  which  are  safe,  durable,  and  handsome 
bridges. 

The  country  bounding  this  river,  until  you  pass  Little  Falls, 
is  broken,  gradually  sloping  from  the  alluvial  flats,  until  it  rises 
to  hills  and  heights  mountainous.  These  elevated  lands  are 
good  for  wheat  and  pastures.  The  flats  and  alluvials,  immedi- 
ately bordering  the  river,  are  rich  and  excellent ;  very  product- 
ive in  every  species  of  corn  and  grass. 

Extensive  farms,  tine  settlements,  and  handsome  villages,  pre- 
sent themselves  to  the  view  of  the  traveller,  as  he  advances  up 
the  Mohawk.  These  are  interspersed  with  pcrpendiculf""  led- 
ges of  rocks,  topped  with  projecting  fragments,  threatening  in 
their  aspect;  dreadful  precipices,  which  cause  the  pallid  chill; 
araall  streams  of  water  spouting  from  the  lofty  clefts  of  rocks  ; 
and  bolder  cascades,  rolling  from  rude  cragged  steeps,  to  please 
the  eye  and  excite  admiration. 
Fifteen  miles  above  Schenectady  is  Amsterdam,  a  handsome 


II 


jt^i 


f,l-  .1 


l:J, 


1   i 


fiii 


50 


MEDICAL  SKETCHES. 


▼illage,  Hitiialed  on  the  north  sale  of  the  Mohawk.  Here  the 
turnpike  crosses  Chuctenunda  creek,  a  small  rivulet.  One  hund* 
red  rods  above  its  mouth,  the  stream  fulls  one  hundred  and  twen- 
ty feet ;  on  which  are  a  numlier  of  mill-seals.  There  are  now 
in  operation  at  this  place,  hve  mills  for  grain,  four  saw-mills,  two 
fulling-mills,  two  oil  mills,  a  tri[)-hammer,  and  an  extensive  iron 
manufactory.  'I'his  place  may  accommodate  an  increased  num- 
ber  of  water  works,  to  aid  manufactories. 

Eight  miles  above  Amsterdam,  the  turnpike  passes  Kingsbury, 
a  village  of  little  nole  ;  and  two  miles  farther,  immediately  on 
the  bank  of  the  Mohawk,  Cahnawaga  village  of  aboriginal  mem- 
ory, as  being  once  the  residence  of  a  part  of  the  Mohawk  tribe 
of  liidians  ;  where  at  this  day,  are  to  be  seen  their  orchards  of 
apple-trees.  These  last  villages  are  within  the  limits  of  Johns- 
town. The  principal  village  of  this  town  is  situated  four  miles 
jiorlh  of  these ;  where  the  courls  of  the  county  hold  their  ses- 
sions. The  last  is  a  very  beautiful  village,  a  place  of  consider- 
able traffic,  which  increases  with  the  population  of  the  country. 

About  fifty  years  ago,  Sir  VVit,liam  Johnson  conducted  a 
few  setllers  to  this  tract,  then  a  wilderness;  who  enjoyed  their 
new  habitation  in  peace  but  a  short  period.  They  were  conv 
pellod,  during  the  revolutionary  war,  to  seek  places  of  more  se- 
curity, in  the  older  towns  on  the  Hudson,  and  at  Schenectady ; 
and  did  not  return  until  Johnson,  the  leader  of  the  enemies  o4" 
Ihe  revolution  in  the  northern  district  of  New-York,  with  the 
hostile  Indians  under  his  control,  were  expelled  the  country. 

After  passing  some  fine  settlements,  well  built  conmiodious 
houses,  and  farms  under  a  good  cultivation,  we  arrive  at  Little 
Falls,  a  compact  settlement  of  fifty  houses,  unpleasant,  surround- 
ed with  broken  crags  and  huge  rocks;  a  site  commodious  for 
niauul'actoritri,  which  rocpiire  the  aid  of  water.  This  is  a  vil- 
lage of  the  town  of  H(^rkiuier,  of  considerable  note,  having  a 
population  in  1310,  of  nearly  three  thousand  inhabitants,  seven- 
ty-ei;^lit  miles  from  Albany.  Here  tiie  alluvial  grounds,  on  the 
bonier  of  the  Mohawk,  are  very  extensive.  They  were  known 
by  the  fiiot  settlers  of  this  countr}^  by  the  name  of  German  flats, 
as  were  other  alhivials,  at  diifircnt  jminls  up  this  river  to  Rome., 


CAMPAIGN  OP  1813. 


51 


*the  genei-ftl  face  of  the  country  presents  a  rich  soil,  i^Itivated 
by  the  hands  uf  an  industrious  yeomanry.  This  is  an  ohl  set- 
tled town.  The  village  of  Herkimer  is  very  pleasant,  exhibit- 
ing considerable  taste  and  opulence.  In  its  vicinity,  the  turn- 
pike crosses  West-Canada  creek,  %vhich  empties  itself  into  the 
Mohawk  from  the  north. 

The  next  most  important  town,  through  which  the  Mohawk 
turnpike  passes,  is  the  village  of  Utica,  within  the  bounds  of 
Whitestown,  ninety-three  miles  from  Albany.  This  village, 
from  its  (irst  beginning,  which  was  since  the  revolutionary  war, 
has  increased  to  a  size  which  surpasses  belief.  One,  knowing 
the  state  of  this  country  thirty  years  ago,  ignorant  of  its  rapid 
improvement,  might  naturally  suppose,  that  at  a  distance  of  our 
hundred  miles  west  from  Albany,  he  would  find  himself  buried 
in  a  wilderness,  where  nature  is  beheld  in  its  most  rude  and 
savage  state.  The  sceneries  up  the  Mohawk  are  circumscribed 
in  all  directions,  by  diversified  broken  ranges  of  hills,  and  in- 
tervening vallies.  While  travelling  on  a  road  up  and  dowir. 
and  whether  rising  on  hills,  or  descending  to  the  plains  below, 
no  distant  prospects  are  to  be  seen.  But  as  we  approach  the 
head  of  the  Mohawk,  a  new  world,  in  a  high  state  of  cultivation, 
is  displayed  to  the  sight.  Those  stupendous  mountains  and 
precipices,  which  accompanied  us  from  stage  to  stage  up  the  Mo- 
hawk, are  either  left  behind,  or  gradually  sink  anil  are  lost  in 
the  vast  extensive  plains  'efore  us.  We  view  the  surrounding 
and  more  remote  sceneries  not  only  with  delight,  but  with  won- 
der and  amazement.  The  transition,  though  not  very  sudden? 
is  like  enchantment. 

Utica  is  situated  on  the  south  side  of  the  Mohawk.  Having 
passed  over  a  level  road,  twelve  miles  or  more,  we  enter  the 
village  over  a  durable  roofed  bridge.  The  surrounding  country 
is  a  vast  plain,  open  in  all  directions,  having  no  intervening 
hills,  and  few  tracts  of  wood-land,  to  intercept  the  sight.  This 
champaign  country  extends  to  Lake  Erie,  two  hundred  miles 
west.  Every  thing  is  new  ;  at  the  same  time,  taste,  riches,  and 
opulence,  are  generally  displayed.  These  are  proofs  demonstra- 
live  of  a  coil  highly  luxuriant,  and  a  populaliou  very  iudustri- 


I  . 


!    I 


■■(  ■  I' 


Ih, 


« 


MEDICAL  SKETCHES. 


ii ' 


Ii 


i  I   M 


mi 


"n 


1  ■    I 


out.  The  artisan,  as  well  as  the  husbandman  and  merchant^ 
here  increase  in  riches.  Mills,  factories,  and  mechanic  shops, 
are  seen  in  all  direction's.  In  this  village  are  two  houses  for 
divine  worship.  y  ..  : -,     -        v 

During  the  revolutionary  war,  this  was  the  site  of  Port  Schuy- 
ler, whicli  will  be  long  known  in  history.  Utica  contains  be- 
tween three  and  four  hundred  houses  compact,  and  a  i>opulation 
of  two  thousand  souls.  The  commerce  of  the  extensive  west- 
ern country  concentrates  at  this  |)oint,  about  fifteen  miles  belovr 
the  head  of  boat  navigation  on  the  Mohawk. 

Whiteshorough,  the  second  village  as  to  importance,  within 
the  limits  of  Whitestown,  and  situated  four  miles  north-west  of 
Utica,  seems  on  account  of  the  uninterrupted  population,  to  be 
9.  continuation  of  the  last  village.  Its  tirsl  settler  was  Hugh 
White,  afterwards  a  Judge  of  one  of  the  courts.  He  emigrated 
from  Connecticut,  in  the  year  1785 ;  and  was  the  first  who  had 
/esolution  to  adventure  into  these  dreary  regions,  unfrequented, 
except  by  savage  beasts,  and  more  savage  men. 

Whitesborough  village  is  beautiful  and  elegant.  It  comprises 
•ne  hundred  houses,  and  seven  hundred  inhabitants. 

New-Hartford,  the  third  village,  is  situated  west  from  Utica. 
This  also,  is  a  continuation  of  the  last.  Farms,  in  a  state  of  high 
(tultivatioii,  here  present  themselves  to  the  view  of  the  passing 
traveller. 

Whitestown,  with  its  villages,  UMca,  Whitesborough,  and 
New-Hartford,  exhibit  more  important  improvements  in  com^ 
merce,  manufactories  and  agriculture,  than  any  town  of  the  same 
age,  in  the  state  of  New-York,  perhaps  in  the  United  States. 
The  public  buildings  are  superb,  and  many  of  the  private  man- 
sions finished  in  a  style  of  elegance.  They  are  such  as  would 
be  thought  ornamental  in  the  older  towns  of  the  Atlantic  States. 
The  face  of  the  country,  with  its  various  improvements  and  em- 
bellishments, give  the  spectator  some  idea  of  its  wealth  and  presr 
ent  resources,  and  what  may  be  its  future  opulence,  arising 
from  their  rapid  increase.  But  when  he  reflects  ujion  the  recent 
date  of  their  origin,  the  many  dangers,  hardships  and  privations, 
the  first  settlers  had  to  encounter,  to  make  themselves  only  com- 


CAMPAIGN  OP  1813. 


53 


fortable,  he  is  struck  with  admiration ;  and  when  he  learns,  that 
Uiese  vast  improvements,  from  a  wild  state,  nre  the  proiluce  of 
only  thirty  years  of  industrious  labour,  he  is  lost  in  astonish* 

Dient 

Uf)on  the  ancient  site  of  fort  Stanwix  stands  the  handsome 
village  of  Rome.,  thirteen  miles  N.  W.  from  Utica.  During  the 
revolutionary  war,  it  was  an  out-post  surroundeil  with  vast  for- 
ests in  the  wildest  state,  now  encircled  with  luxuriant  helds ; 
T\hich  amply  repay  the  industrious  husbandman  with  abundant 
harvest  for  his  labour.  Fort  Stanwix  was  built  by  the  British 
in  1738;  and  was  evacuated  at  the  close  of  the  French  war,  af- 
ter the  conquest  of  Canada,  and  was  suffered  to  fall  to  ruin ;  but 
during  the  war  with  Britain,  was  rebuilt,  and  maintained  as  a 
frontier  garrison  by  the  revolutionists ;  and  with  a  number  dT 
posts,  from  fort  Schuyler  to  Schenectady,  on  the  Mohawk,  form*- 
cd  a  communicating  line  of  fortifications,  to  prevent  surprise, 
and  protect  the  interior  settlements  from  incursions  and  deprev 
dations  of  the  enemy,  and  his  savage  allies. 

The  first  settlers  of  Rome  were  Dutch.  Its  present  popula- 
tion consists  of  emigrants  from  the  eastern  states  ;  as  do  those 
of  Whitestown  and  its  villages.  The  Mohawk  passes  withia 
half  a  mile  of  its  village,  composed  of  thirty  houses ;  on  which 
are  seats  for  water  machinery,  which  adds  value  to  the  position. 
It  was  in  this  town,  that  General  Herkim«:r  was  killed  in  an 
action  with  the  Indians,  during  the  revolutionary  war.  The 
canal,  which  unites  the  head  waters  of  the  Mohawk  and  Wood- 
Creek,  passes  through  this  town. 

From  Utica,  the  course  of  Sackelt's  Harbour  is  nearly  N.  N. 
West ;  to  Otswego  on  Lake  Ontario,  is  nearly  west.  After 
leaving  the  upper  branches  of  the  Mohawk,  and  passing  the  high 
lands,  which  separate  its  waters  from  the  smaller  streams  of 
Black  River,  which  empties  into  Sackett's  Harbour ;  the  coun- 
try down  is  variously  uneven,  mountainous,  precipitous,  and 
rugged  with  rocks.  The  forests  are  variegated  with  several 
species  of  hard  and  soft  woods,  and  evergreens.  Many  scene- 
ries pass  in  review  of  the  traveller,  as  he  progresses  down  Black 
River. 

6 


!v ,  1 


'■ 


I- 


I } 


\l 


I 


5i 


I^IEDICAL  SkETCrfER 


This  river  has  its  sources  in  the  high  lands,  norllj  of  Littl* 
Falls  and  the  Mohawk.  Its  course  is  N.  N.  W  ;  and  empties 
itself  into  a  large  bay,  in  which  is  Sackett's  Harbour,  ninety 
miles  from  Utica,  and  one  hundred  and  ninety  six  miles  N.  W; 
from  Albany. 

Twelve  miles  north  from  Utica,  is  the  town  of  Trenton,  re- 
markable on  account  of  a  cataract  in  the  vicinity  of  the  village. 
The  water  tumbles  over  successive  strata  of  rocks,  from  an  emi- 
nence of  one  hundred  feet.  The  rapids  below  are  confiP"i 
within  contracted  limits  by  rocks  which  rise  per|)endicularly 
one  hundred  feel  or  more,  overspread  with  evergreens.  The 
scene  from  below,  although  circumscribed  within  narrow  bounds, 
by  the  surrounding  broken  highlands  and  cragged  precipices,  is 
romantic  ;  uhile  the  whole  assemblage  is  truly  9ublime.  The 
soil  of  this  town  is  good  ;  the  forests  are  variegated  with  vari- 
ous species  of  both  hard  and  soft  wood,  and  evergreens.  Its 
'  principal  village  contains  about  eighty  houses. 

On  the  route  down  Black  River  from  Trenton,  we  pass  Bow- 
en's  settlements,  Steuben,  Boonville  and  Leyden  ;  the  last  is 
thirty  three  miles  from  Utica,  and  one  hundred  and  fifteen  N.  W. 
from  Albany,  comprising  a  tract  of  country,  with  thinly  scatter- 
ed settlements,  and  inconsiderable  villages. 

The  next  town  of  much  consequence,  is  Martinsburgh,  forty 
eight  miles  from  Utica,  and  one  hundred  and  thirty  N.  W.  from 
Albany  ;  it  is  in  a  fine  state  of  cultivation.  The  face  of  the 
land  is  gently  rising  and  falling.  The  soil  is  rich.  The  count- 
ry from  this  to  Brownville  abounds  with  lime-stone.  The  vil- 
lage of  Martinsburgh  contains  between  thirty  and  forty  houses, 
county  buildings,  a  house  of  public  worship,  two  distilleries,  a 
saw-mij,,  grain-mill,  paper-mill,  taverns  and  stores. 

Fifty  seven  miles  north  from  Utica,  we  arrive  at  Lowville, 
one  hundred  and  fifty-nine  miles  N.  W.  from  Albany,  one  of 
the  most  imi)roved  towns  on  Black  River.  The  village,  laid  out 
in  squares,  is  beautiful,  comprising  fifty  houses ;  many  built  in  a 
style  of  taste  and  elegance.  Here  is  an  academy  ;  the  building 
is  handsome.  An  elegant  and  spacious  edifice  is  improved  as  an 
hotbl.    The  lands,  which  lie  in  gentle  swells  and  ea«y  vales,  are 


■       j^feasa 

H       veys  ( 

H       only  t 

H       Aud  af 

1 

B       thiuly 

H       cmerg 

I 

1       ^"  ^^ 

9    *''^''  ^" 

S        low  is 

Wm       two  h 

IB 

9       (ten  y 

9       cardin 

i9       Copen 

mM       is  disl 

^H  Th( 
9        Bii'^S> 

8    "^* 

^       on  the 

^H  twelv( 
■       The  ( 

^H  srecte 
H       of  brie 

H       are  el 

H       brick, 

1       ed  as 

■       its  of  t 

1       mills, 

1       with  a 

^       are  go 

■       are  in 

H       terials 

I       Black 

1       from  h 

'^       is  carr 

"i       river ! 

•1 

r 

i  ^'  ' 

CAMPAIGN  OP  1813. 


.$5 


(^feasant.  The  soil  is  of  giiperior  quRlity.  Th'^s  dislrict  con- 
veys to  the  mind  of  the  trRveller,  that  its  inimliitnnts  enjoy  not 
only  the  neccssariea  anil  conveniences  of  life,  but  possess  wealth 
«U(i  affluence. 

Six  miles  north  of  Lowville  is  Denmarlv ;  the  setllemonts  are 
thinly  scattered,  exhibiting  a  country  but  just  bee^innins;  to 
emerge  from  its  wild  state.  However,  over  an  area  of  twenlj' 
two  thousnnd  acrrs,  the  ac;preeate  population  is  considerable. 
On  Deer  creek,  which  cm])tie8  into  Black  river,  is  a  perpendic- 
ular fall  of  one  hundred  and  seventy-five  feet.  The  stream  ht'r 
low  is  bounded  the  distance  of  eighty  rods,  by  calcarious  rocks, 
two  hundred  feet  in  height.  Here,  since  its  first  settlement, 
(ten  years)  have  been  erected  six  saw-mills,  two  grain-mills,  two 
carding  machines,  two  clothiers  works,  three  s;)inning-machine6. 
Copenhagen  a  small  village,  lies  above  llic  falls.  Denmark 
is  distant  one  hundred  and  fifty-six  miles  N.  W.  from  Albany. 

The  distance  from  Denmark  to  Watertown  is  aliout  twenty 
Biile^,  and  one  hundred  and  seventy-six  miles  N.  W.  from  Alba 
ny.  This  is  a  pleasant  growing  village,  situated  immediatelj' 
on  the  south  side  of  Black  River.  From  a  wilderness,  within 
twelve  years,  it  has  become  a  place  of  considerable  importance. 
The  courts  for  the  county  have  their  sessions  here ;  where  is 
erected  a  commodious  court-house  of  wootl,  and  an  arsenal  buill 
of  brick.  The  village  also  contains  sixty  houses,  some  of  which 
are  elegant;  likewise  a  spacious  and  well  built  academy  ol 
brick,  which  in  March,  April,  June  and  July,  1813,  was  improv- 
ed  as  an  hospital  for  the  United  States  army.  Within  the  lim- 
its of  the  village,  are  a  paper-mill,  two  corn  mills,  three  saw- 
mills, a  carding  machine^  three  taimeries,  and  a  printing-office, 
with  a  number  of  mechanic  shops.  The  lands  in  this  vicinity 
are  good  ;  cultivation  is  in  an  improving  state  ;  the  inhabitants- 
are  indurlrious  and  becoming  rich.  Lime-stDne  and  other  ma- 
terials for  building  are  found  in  abundance,  from  the  sources  of 
Black  River  to  its  mouth.  Watertown  is  situated  four  miles 
from  boat  navigation  on  Lake  Ontario.  A  considerable  traffic 
is  carried  on  between  this  place  and  Montreal,  by  the  lake  and 
Tiver  St.  Lawrence.^. 


PWIfWWPP'"""       !•■ 


66 


jMEDICAI.  rSKETCIlEK. 


t 


ill 


i       Ml 


|i 


From  Wntcrtoun  to  SacKelt's  Hurboiir,  we  pass  Browiivillc. 
a  town  of  great  extent,  comprising  within  its  limila,  a  lengtli  ot 
twenty-four  milcB,  and  a  bretuUh  of  twenty-two.     It  is  bounded 
on  the  N.  W.  by  St.  Lawrence,  S.  W.  l)y  Lake  Ontario,  soutk 
by  Black  Itiver,  on  the  east  by  the  town  of  Le  Rny.     The  soil 
is  rich  and  fertile.    Within  tiic  limits  of  this  town,  there  arc  no 
liills  ;  the  surface  of  the  earth  gently  uneven.     This  town  was 
first  settled  about  fourteen  years  ago,  by  John  Brown,  from 
Pennsylvania  ;  since  which,  its  population  has  increased  in  an 
astonishing  manner.     Tliere  were  by  the  census,  in  1810,  1G02 
inhabitants,  mostly  emigrants  from  Pennsylvania,  and  the  New- 
England  States.     This  town  is  well  watered,  and  abounds  with 
lime-stone,  as  docs  all  the  country  in  this  vicinity.     Several 
islands  in  Lake  Ontario  and  St.  Lawrence,  are  within  the  lim- 
its of  Brownville.     The   village  situated  on  the  north  of  Black 
River,  contains  thirty  houses,  a  number  of  stores  and  mills,  and 
is  a  place  of  considerable  mercantile  business,  which  is  carried 
on  with  Montreal,  by  St.  Lawrence.     This  is  a  pleasant  village, 
and  will  from  its  situation,  become  in  a  few  years,  a  place  of 
great  im[»ortancc.  ,       • 

General  Brown  is  the  son  of  JoUn  Buown,  from  whom  this 
town  derived  its  name.  From  a  private  citizen,  in  the  course 
of  three  years,  he  was  elevated  to  the  first  grade  in  the  army. 
The  battles  fought  on  the  Niagara,  by  the  army  under  his  com- 
mand, have  given  to  the  American  soldiery,  a  character  for  pa- 
tience, perseverance,  and  undaunted  bravery,  surpassed  by  none. 
A  military  hospital  was  established  at  Brownville,  two  last 
years  of  the  war.  Its  position  was  favorable  to  such  an  estab- 
lishment ;  as  there  is  a  water  communication  between  this  place 
and  Sacket's  Harbour,  the  centre  of  active  operations  on  the 
northern  frontiers. 

The  country  in  this  vicinity,  especially  those  posts  bordering 
on  the  bays  of  Lake  Ontario,  like  all  new  countries,  are  con- 
sidered unhealthy. 

Sackett's  Harbour  was  the  only  secure  port  for  a  navy  on  the 
lake;  where  Commodore  Chauncey  had  hauled  up  the  armed 
flotilla,  during  the  cold  season,  waiting  the  breaking  up  of  win- 


iSl'i 


CAMPAIGN  OP  1813. 


5,r 


fer,  \o  r*»-aMUmp  operations  against  the  enemy.  To  this  flotilla, 
was  adiled  h  ship  of  twenty-eiijht  c;uns,  l)niU.  entirely  of  green 
timber  from  the  wilderness,  within  three  months ;  and  which 
was  in  preparation  to  sail,  as  soon  as  the  ol'structions  formed  hy 
ice  were  removed.  Sacket's  Harhour  was  protected  by  two  bat- 
teries, and  two  block-houses.  This  post,  the  preceding;  cam- 
paign, had  been  occupied  hy  militia.  The  hospital,  so  denom- 
inated, was  in  a  tilthy  condition.  From  information,  the  win- 
ter epiilcmic  had  proved  very  mortal  among  the  troops.  The 
disease  at  this  period,  (iMarch  10,  1813,)  had  not  disappeared. 
The  few  existing  cases  were  attended  with  symptoms  less  formi- 
dable than  at  its  commencemrnt. 

Information  had  been  received,  that  the  enemy  was  conceft- 
trating  his  disposable  force,  at  Kin^iston,  Upper  Canada,  distant 
thirty  miles.  Apprehensive  of  an  attack  from  him,  General 
Dearborn  ordered  a  temporary  hospital  establishment  at  Water- 
town,  twelve  miles  east  of  the  harbour,  on  black  river,  where  the 
sick  would  be  less  exposed  to  depredations  of  the  enemy.  This 
precaution  was  more  necessary,  as  the  sick  could  not  be  accom- 
modated at  the  harbour,  within  the  line  of  defence.  An  hospital 
sufficiently  capacious  to  accommodate  100  patients,  was,  within 
ten  days,  estalilislied;  to  which  the  sick  at  the  harbour  were  re- 
moved. Among  the  number  were  about  20  of  General  Pike's 
brigade,  who,  on  their  route  from  Plattslmrgh,  by  way  of  Chatau- 
gay  ixM  Malone,  in  the  month  of  March,  had  badly  frozen  their 
feet  and  toes;  which,  in  almost  every  case,  mortified,  and  requir- 
ed amputation.  At  this  hospital  two  cases  of  the  winter  epi- 
demic were  admitted,  when  the  disease  was  at  its  last  stage.  In 
both  cases  there  were  large  expectorations  of  mucus  uniformly 
mixed  with  blood.  Respiration  was  difllcult ;  diarrhoea  accom- 
panied the  disease.  A  pill  of  one  grain  of  calomel  and  opiuni  '• 
was  directed  night  and  morning :  also  small  doses  of  antimonial 
wine  and  camphorated  tincture  of  opium,  were  administered  at 
intervals  of  three  or  four  hours,  as  an  expectortant ;  likewise 
blisters  and  gentle  emetics.  Under  the  employment  of  the  above 
means,  with  the  addition  of  a  soft  nutritive  diet,  and  wine,  these 
men  were  restored  to  hes^lth.     Tlie  most  prevalent  disease  at 


I  ' 


» 


!'■! 


J» 


MEDICAL  SKETCHED. 


Ml 


1  '1 


tli'iB  period,  March  and  April,  vsere  cougiis,  fevers  of  tlie  synocIr-> 
aI  type,  diarrhinns. 

On  tlie  23d  April,  nn  ordci-  »va8  received,  to  place  the  ho8|>ilal 
under  the  charge  of  surgeon's  mate,  March,  and  lO  repair  to 
Sacketl's  Harbour ;  where,  having  arrived,  information  was  ob- 
tained, that  sixteen  hundred  men,  destined  for  a  secret  expedi- 
lion,  had  embarked  on  Imard  the  fleet,  and  that  commodore 
Chauncy  waited  only  for  n  fair  wind  to  sail.  This  armament,  to 
%vhich  I  was  attached,  wns  commanded  by  General  Dearborn, 
being  coraiwsed  of  a  part  of  General  Pike's  brigade,  one  battalion 
of  Colonel  Kiplev's  regiment,  two  companies  of  New-York  and 
Ealtinwre  volunteers,  200  riflemen,  and  two  companies  of  light 
artillery.  On  the  23th  of  April,  the  fleet  weighed  anchor,  with  a 
favoural)le  breeze,  and  steered  their  course  to  the  head  of  Lake 
Ontario.  On  the  27lh,  at  day-break,  were  in  sight  of  the  Light 
House,  at  the  entrance  of  the  bay  of  Litlle  York,  in  Upper  Can- 
ada. At  eight  o'clock  this  morning,  the  fleet  dropped  anchor 
opponUe  the  batteries,  at  six  hundred  yards  distance,  when  the 
signal  for  debarkation  was  displayed. 

Miijor  Forsyth,  with  two  hundred  of  his  battalion  of  riflemen 
in  baileaus  composed  the  advance.  General  Pike,  who  com- 
manded the  attack  on  shore,  with  three  battalions  of  the  Olh,  1  .'>lh, 
and  I61h  regiments  succeeded  the  advance,  supported  by  Co'o- 
ncl  (now  General)  Ripley,  with  one  battalion,  composed  of  21nt 
regiment,  and  two  companies  ol"  Baltimore  and  New-York  volun- 
teers, under  Colonel  Mc'C lure,  one  company  of  artillery,  com* 
mandcd  by  Major  (now  Colonel)  Eustis. 

Major  Forsyth,  on  approaching  the  shore,  met  a  severe  resist- 
ance from  three  hundred  British  regulars,seven  hundred  Canadian 
militia,  and  a  small  body  of  Indians,  who  occupied  the  high 
^anks  on  the  lake  shore.  Under  a  heavy  lire  from  the  enemy, 
this  coqis  made  good  its  landing,  and  most  gallantly  maintained 
lis  ground  twenty  minutes,  unsupported,  until  General  Pike  and 
Colonel  Ripley  gained  the  land,  when  the  enemy's  line  in  suc- 
cession broke,  fell  back,  rallied,  was  thrown  into  confusion,  and 
r(!trealed  with  precipitation.  General  Pike  immediately  formed 
his  army  in  open  column,  and  pursued   the  fiigitivesi      During 


CAMPAIGN  OP  18lir. 


S9 


ihc  attack  oti  shoro,  th<5  enemy's  l)atterifs  wore  silenced  by  the 
well-Jlirected  fire  of  the  lijjlit  nrmed  ichoonere  of  the  fleet,  at 
which  time  a  small  magazine  took  fire.  A  ship  and  brig  could 
not  approach  within  battering  distance,  on  account  of  shoal 
water. 

Our  column,  at  the  distance  of  four  hundreil  yanis  from  the  ert- 
emy's  batteries,  halted  with  a  view  to  reconnoitre  their  (loaition, 
and  wait  the  bringing  up  of  two  pieces  of  artillery,  under  Mtjor 
Eustis,  who  had  to  encounter  many  olistacles  from  fallen  timber 
and  miry  grounds.  At  this  moment,  the  enemy's  principal  mag- 
azine exploded.  By  this  catastrophe,  General  Pike,  an  ofTiccr 
of  superior  merit,  and  heid  in  the  highest  estimation  by  the  nr* 
my,  received  a  mortal  wound,  which  he  survived  a' few  hours*. 
The  effects  of  this  explosion  were  drca'Iful.  Sixty  rank  and  filo 
were  found  dead  on  the  field,  and  one  hundred  and  eighty  wound- 
ed and  mangled  in  a  most  wretched  and  deplorable  manner,  by 
the  fall  of  stones  which  formed  the  magazine;  to  which  the  ene- 
my, when  he  evacuated  the  battery,  set  fire,  by  mean  of  a  train 
or  slow  match,  prepared  for  the  event  of  abandoning  the  works. 
The  effect  was  similar  to  the  springing  of  a  mine. 

The  remnant  of  the  British  army  fled  with  the  commanding  of- 
ficer, the  Governor  of  Upper  Canada,  who  was  the  first  to  make 
his  escape.  The  commanding  officer  of  the  Canadian  militia,, 
who  had  retreated  to  the  town,  sent  a  flag,  with  terms  of  capita-* 
lation,  when  hostilities  immediately  ceased.  One  article  which 
was  acceded  ♦o  by  General  Dearborn,  was,  that  private  property 
should  be  respected,  and  all  public  property  be  given  up.  This 
article,  conciliatory  to  the  feelings  of  the  inhabitants  of  Little 
York,  and  magnanimous  on  the  part  of  the  victorious  General, 
was  not  violated  ;n  any  of  its  parts,  except  in  one  or  two  instan- 
ces, by  a  few  licentious  soldiers.  These  outrageous  acts  were  dis- 
coantenanced  in  forcible  language,  in  General  Orders ;  and  on 
the  spot  satisfactory  indemnification  was  made,  as  soon  as  the 
damages  were  ascertained  by  the  sufferers. 

A  very  different  representation  of  the  transaction  at  Little 
York  has  been  given.  It  is  not  a  little  astouisbing,  that  an  hfe- 
^j)rian  should  thus  conmit  himself  as  the  author. 


1'^ 


ii; 


'^ 


60 


IVIEDICAL  SKETCHES. 


H;  . 


j! 


'  i 


ll; 


! 


Hi 


It  is  no  npuluj^y  for  this  outraj^c  uii  truth,  that  the  «ul«B(Hnc«2 
of  th(!  alniBive  paragraph  was  extracted  frurn  a  daihf  newspaper 
devoteii  to  a  party  oppoaed  to  the  war.  The  statement  oi'  (he  hiii« 
(orian,  at  the  time  of  ils  publicatiim,  had  lieen  repeatedly  con- 
tradicted hy  oHicial  documents ;  and  ils  ralsity  has  since  been 
proved  by  une(|ijivocal  declarations  of  oillcers  of  hif^h  grade  and 
respectable  standing  in  (he  army,  who  held  commands  in  th<t  ar* 
mament  employed  on  this  expedition.  An  historian,  jKisaessing 
honorable  motives,  upon  conviction  of  his  inconcctn'Bs,  which 
implicated  any  man,  especially  the  commiinding  Gienerul,  in  dis' 
graceful  and  re|»i'oachful  conduct,  would  (eel  himself  bound  to 
make  amjile  reparation  for  the  injury.  Nothing  less  Ihnn  a  full 
and  candid  ackuowicilgmcnt  of  his  error,  or  suppression  of  the 
publication,  can  wipe  away  the  inti'nde<l  stigma,  and  place  the 
author  in  a  magnanimous  light.  The  work  is  in  circuhttion, 
>vith  all  its  malignancy.  Its  poison  is  ditluaed.  It  has  been, 
and  will  be  read  witliout  the  apologetical  note,  for  the  criminal 
publication  of  mere  newspaper  re[iort3,  unsupported  by  oflicial 
documents.  Besides,  the  note  is  only  a  partial  retraction  of  the 
erroneous  statement  made  by  the  author,  which  is,  that  General 
Dearborn  was  immediately  con)|)elled  to  evacuate  the  place, 
with  considerable  loss  ;  while  the  truth  is,  the  oljject  of  the  ex- 
pedition, the  capture  of  the  enemj^'s  fleet,  and  destruction  of  his 
stores,  was  effected  in  all  its  parts.     (See  Note  K.) 

The  army,  with  the  wounded  and  sick,  after  having  undisturb- 
ed possession  of  tlie  place  four  days,  re-embarked.  The  follow- 
ing night  a  gale  of  wind  commenced,  with  rain,  and  continued 
with  violence,  which  prevented  the  fleet  from  sailing  until  7th 
May.  After  a  pleasant  passage  of  twelve  hours,  the  fleet  came 
to  anchor  opposite  the  mouth  of  the  Niagara;  upon  (he  8th  the 
wounded  and  bickwere  landed,  and  encamped  in  tents,  two  miles 
east  of  the  fort,  where  they  remained  until  after  the  capture  of 
Fort  George,  in  Upper  Canada. 

Previous  to  further  movements  of  the  army,  while  arrange- 
ments were  making  to  attack  Fort  George,  General  Dearborn 
hud  been  severely  seized  with  a  fever  of  the  synocljal  type, 
wluch  contiued  him   to  his  bed  more  than  a  fortnight ;    from 


CAMPAIGN  OP  1813. 


ei 


which  he  wnB  not  rrrovennl  when  Uu*  nrmy  wis  in  I'cndinniii  to 
movr.  Nutwilhfllnnilinp:  liiii  l>n()  Htnte  of  hcttllh,  he  acr(>ni|i»ni> 
rd  the  ex|HMliti(>n  ni^niniit  l<\irt  (jieorp  in  o|i|NMition  to  the  o|iin- 
iun  of  hifl  phyHJciuns,  and  nuHinst  icinonstrxnctH  or  the  ofl'icers 
of  his  nrmy  ;  persuaded,  hr  they  were,  timt  the  nnavoitlable  cx- 
l>oi«iire  to  Nv^atlier  nnd  fiitij^iie  attendin<{  ^^oldd,  under  his  state 
of  debility,  prochice  a  rela[)se,  and  endanger  liis  life,  whereby 
•ubsecjuent  oiieratiuns  of  the  army  ng:  inat  the  enemy  might  be 
retarded. 

The  assault  upon  Fort  Oeorc;e  was  commenced  on  the  25th, 
and  continued  the  20th,  from  Fort  Niagara  and  other  batteries 
recently  erected,  by  a  heavy  cannonade  under  the  direction  of 
Colonel  (now  Hrigadier  General)  M.  Poktj".  The  fire  was  bo 
well  directed,  that  Fort  George  was  silencetl  ;  the  Block  House 
and  other  buildings  were  set  on  fire  by  hot  shot,  and  consumed. 
This  was  preparatory  to  the  grand  assault.  May  27th  the  army 
crossed  the  strait  in  three  divisions,  under  the  immediate  com- 
mand of  General  Lkwis.  The  brigades  of  Generals  Boyd  and 
WiNDKR  composed  the  columns  of  attack,  preceded  by  a  detach- 
ment of  six  hundred  men,  commanded  by  Colonel  (now  Gener- 
al) Scott.  The  brigade  of  General  Chandler  was  a  column 
of  reserve. 

These  several  brigades  embarked  in  boats  at  dawn  of  day, 
four  miles  east  of  the  outlet  of  Niagara  Strait.  The  boats  mov- 
ed across  tlie  moutli  of  the  Strait,  in  a  line  parallel  with  the  north 
sliore  on  the  Canada  side,  at  a  distance  of  two  miles  from  the 
land  in  a  west  direction,  until  they  were  opposite  the  point  desig- 
nated for  del)arkation.  The  boats  then  wlieeled  by  brigades 
to  the  south,  and  approacheu  the  shore  in  good  order.  This 
point  was  one  mile  north  of  the  village  of  Newark.  The  move- 
ment of  "ie  troops,  exposed  to  the  full  view  of  the  enemy,  gave 
him  time  to  form  his  line  most  advantageously  to  oppose,  from 
the  high  bank  of  the  lake  shore,  their  landing.  The  enemy's 
line  was  supported  on  his  right  flank  by  a  battery  ;  opposed  to 
which  was  an  armed  schooner,  v.hile  four  armeU  scboeuers 
covered  the  lunUing  of  the  army. 

0 


Hi 


i 


I   I 


t 


ei 


MEDICAL  SKETCHES. 


HI 


■ 


I 


i   ] 

1 

,1 
.1 

Colonel  (now  General)  Sgoxx,  with  the  lipht  trocps,  effected 
his  landing  under  a  blaze  of  musketry  from  two  thousand  British 
regulars  and  Canadian  militia  ;  and  twice  attempted  to  rise  the 
bank,  but  fell  back,  and  waited  for  the  first  brigade  under  Gen- 
eral Boyd  ;  when  the  enemy,  repulsed  at  every  point,  retreated 
in  disorder.  The  enemy  was  pursued  through  the  village  of 
Newark,  to  within  three  miles  of  Queenstown,  when  the  pursu- 
ing troops  were  ordered  to  retire,  by  the  orders  of  General  Lkwis. 
After  the  action  there  were  found  on  the  field  of  battle,  of  the 
United  States'  troops  27  killed,  and  87  wounded;  of  the  British 
102  killed,  and  175  wounded.  The  enemy  halted  the  following 
night  at  Queenstown  ;  whence,  after  collecting  his  scattered 
troops,  the  next  morning  at  dawn  of  day,  he  took  up  his  line  of 
march  to  Burlington  Heights,  at  the  head  of  the  lake.  On  the 
28th  two  brigades  under  the  command  of  General  Chandler 
were  ordered  to  pursue  the  retreating  enemy.  At  C tony  Creek 
a  subsequent  battle  ensued,  unfortunate  in  the  result,  although 
the  enemy  was  beaten.  Generals  Chandler  and  Winder  were 
made  prisoners.  .         , 

The«e  several  actions  gave  us  an  additional  number  of  wound- 
ed men.  Many  capital  operations  were  performed,  both  upon 
the  Americans  and  British,  after  these  several  actions. 

The  lands  in  the  vicinity  of  Niagara  were  wet  at  this  season 
of  the  year.  Upon  this  wet  ground  the  flying  hospital  was  en- 
camped, for  want  oi  better  accommodations.  Many  of  those 
wounded  at  Little  York  died  with  typhous  fever,  accompanied 
with  diarrhoea.  The  condition  of  the  wounds  generally  was 
bad. 

Hnving  experienced  in  the  short  period  of  four  weeks,  that  our 
present  encampment  was  unsuitable  for  a  hospital,  and  its  un- 
healthy i)Osition  having  been  reported  to  the  Commander  in  Chief, 
an  order  was  received  subsequent  Ut  the  last  battles,  v  hich  had 
vastly  increased,  the  list  of  sick  and  wounded,  to  explore?  situation 
more  healthy.  Lewistown,  eight  miles  up  from  the  outlet  of  the 
Strait,  presented  the  most  eligible,  on  that  frontier.  At  this 
point  on  the  Strait,  and  one  mile  east  on  the  ridge  road,  the  land 
is  more  elevated,  gravelly  and  dry.     To  this  place  the  sick  and 


CAMPAIGN  OP  1813. 


63 


wounded,  about  two  hundred,  were  removed  from  Fort  Niagara, 
the  middle  of  June.  By  the  first  of  August  the  patients  were  in- 
creased in  number  to  between  six  and  seven  humlrcd,  and  were 
comfortably  accommo<lated  in  two  spacious  barns,  and  hospital 
tents.  Here  bunks  and  bed-sacks  filled  with  straw  were  furnish- 
ed each  individual.  The  wounds  immediately  assumed  a  more 
healthy  appearance,  produced  in  part,  by  a  change  from  an  insa- 
lulirious  to  a  more  healthy  position.  A  liberal  supply  of  milk  con- 
tributed not  a  little  to  this  salutary  effect. 

Typhous  fever  and  diarrhoea  pervaded  the  army  after  their  ret- 
rograde march  from  Stony  Creek.  Numbers  who  had  been  ad- 
mitted into  this  hospital  improved  also  in  their  health  by  change 
of  position  and  milk  regimen,  with  which  they  were  liberally  sup- 
plied. This  bland  diet,  well  suited  to  the  condition  of  the  sick 
and  convalescents,  and  proved  more  beneficial  than  medicine,  to 
check  the  diarrhojas,  which  prevailed  from  the  time  the  troops 
arrived  on  the  frontiers. 

M-ny  of  the  soldiers,  when  embarked  at  Sackett's  Harbour,  had 
but  a  short  t<me  previously  recovered  from  the  epidemic  of  the 
preceding  winter.  During  their  passage  to  Little  York,  they 
were  night  and  day  unavoidably  exposed  to  the  weather,  and  so 
much  crowded  on  board  the  transports,  that  little  opportunity 
was  had  for  repose.  After  the  attack  upon  Little  York,  and 
when  the  army  had  re-embarked,  the  troops  were  exposed  a  num- 
ber of  days  on  the  decks  of  the  vessels  to  a  violent  storm  ;  dur- 
ing which  period  they  were  constantly  soaked  w  ith  rain.  Un- 
der these  circumstances,  diarrhu3a»  supervened  most  universally 
among  the  men.  After  landing  at  Niagara,  the  men,  in  many 
instances,  were  attacked  with  typhous  fever;  wliich  became 
more  frequent  after  the  capture  of  Fort  George.  Subsequent  to 
the  retrograde  march  of  the  army  from  Stony  Creek,  a  combina- 
tion of  typhous  fever  and  diarrhea  was  very  general. 

It  may  not  be  improper  to  uotice,  that  the  greater  part  of  the 
army  were  recruits,  and,  previous  to  the  assault  on  Fort  George, 
had  either  marched  or  been  trans[)orted  the  distance  oi  .uur  hun- 
dred miles,  by  rapid  movements,  exposed  to  the  weather  and  its 
Tfarying  changes^  during  Mart  a  and  April,  which  months,  in  tLe 


ill 


\  v 


n  I 


'■'"I 


■  i 


"  I 
I 


I 


■  ^  «ii»V»''  I'  I'ffP 


J  M   ■  i;iJppef^iOTfVPgn|pf^ 


n 


i  <: 


Si' 

n, 


64 


MEDICAL  SKETCHES. 


northern  district,  were  experienced  severely  cold  and  wel.  The 
brigade  of  Generals  CuANDiiER  and  Pikk  encountered,  while  on 
their  route  from  Lake  Chainplain  to  Sackelt's  Uiirbour,  a  violent 
sturrn  of  snow,  during  (he  month  of  IMarcli,  in  the  wilds  which 
border  the  river  St.  Lawrence.  Other  detachments,  after  a 
inarch  of  two  hundred  miles,  were  transported  up  Lake  Ontario 
in  batteaus,  in  April  and  May.  The  vernal  months  of  this  j'ear 
were  wet  and  cold.  During  the  greater  part  of  these  routes,  the 
men  were  destitute  of  covers  to  shelter  them  from  the  inclemen- 
cy of  the  climate. 

An  army  on  expeditious  movements  have  little  or  no  opportu- 
nity given  to  pitch  their  tenls,  and  time  too  short  suitably  to 
prepare  their  rations.  Their  meals  are  generally  cold  ;  their 
lodgings  hard,  wet,  and  comfortless. 

Such  long  unremitted  exposures  to  cold  and  excessive  fatigues, 
with  a  diet,  which,  under  existent  circumstances,  could  not 
prove  nutritious,  exhausted  the  vital  principle,  and  diseases  super- 
vened in  the  following  order:  first,  diarrh(Bas  ;  next,  typhous  fe- 
ver; and  then  typhous  fever  and  diarrhaw  combined. 

The  productions  of  animal  putrefaction  and  excrementitious 
materials  wer«  also  sources  of  these  diseases.  Armies  always 
accumulate  these  noxious  principles  about  their  encampment  in  a 
few  days,  Avheu  attention  is  not  called  to  their  daily  removal. 
The  bread  was  believed  to  be  another  source  of  these  complaints. 
;it  was  bad  and  untit  lor  nutriment  in  several  respects.  In  some 
instances  thc-flour  furnished  had  commenced  a  fermentative 
process,  which  rendered  the  bread  sour ;  in  others,  had  progres- 
sed so  far  to  a  state  of  putrefaction,  that  its  nutritive  property 
was  destroyed.  At  one  period,  tlie  flour  issueil  was  believed  to 
be  adulterated  with  plaister  of  Paris,  (gypsum)  ^^round  f'V.f.  So 
large  a  pro])ortion  of  this  last  article  was  mixed  with  the  floui. 
that  it  was  detected  in  the  bread  by  the  eye.  This  adulteration 
was  also  known  by  its  specific  weight. 

Excepting  a  few  hot  days  in  the  first  week  of  June,  the  re- 
mainder of  that  month  and  July  following,  were  cold  and  un- 
pleasant for  the  season.  The  month  of  August  was  extremely 
hot  and  oppressive,  as  were  the  first  weeks  in  September.    Tl»e 


a 


CAMPAIGN  eF  1818. 


C0 


last  or  tills  month,  the  weather  hecame  very  pleasant,  and  the 
troops  generally  more  healthy ;  while  those,  who  had  been  pros- 
trated and  wasted  by  disease,  convalesced  in  a  rapid  manner. 
At  the  flying  hospital  encampment,  Lewistown,  the  sick  partic- 
ularly improved  in  their  health;  the  convalescents  experienced 
no  relapses ;  nor  were  they  seized  with  any  new  form  of  disease. 
The  convalescents  were  put  on  light  duty  at  that  place ;  and 
out  of  some  hundreds  of  these,  not  more  than  three  were  return- 
ed to  the  hospital  during  the  campaign.  This  is  full  evidence 
of  the  healthy  position  of  this  cantonment.  The  means  em- 
ployed to  preserve  it  in  a  state  of  cleanliness  were  conducive 
to  ameliorate  the  bad  condition  of  the  men  who  were  admitted 
into  the  hospital ;  yet  these  means  could  not  have  added  salu- 
brity to  its  natural  situation,  being  seventy  feet  above  the  sur- 
face of  the  lake  waters. 

Fort  George  and  Newark,  from  their  position,  might  be  sup- 
posed healthy  also.  The  site  of  these  places  is  elevated  50  feet 
above  the  surface  of  the  lake.  The  forests  in  their  vicinity  had 
been  cut  and  cleared  away  for  cultivation.  The  countrv  to  a 
great  extent  is  level,  without  a  hill  until  we  arrive  at  Queenstown 
height.  Wherefore,  from  the  land-side  of  the  position,  a  free 
circulation  «f  air  might  be  expected.  The  daily  breezes  from 
the  wide  expanse  of  the  lake,  were  cool  and  refreshing,  during 
the  hot  season.  The  encampment  of  the  army  appeared  clean. 
Newark  p'  svious  to  the  war,  was  thought  healthful,  as  it  was  a 
most  dei'ghtful  village.  Notwithstanding  all  these  favourable 
appearances,  the  army  did  not  enjoy  so  much  health,  as  had 
been  anticipated  from  its  situation.  The  village  of  Newark,  in- 
terposed between  the  lake  and  encamping  ground,  was  an  ob- 
struction to  the  breezes  from  that  quarter.  The  east  bank  of 
the  Niagara  strait  was  bounded  by  an  immense  forest,  which 
extended  up  the  strait  to  the  south ;  in  which  quarter,  was  also 
a  ridge  of  land,  one  hundred  feet  in  height.  These  severally 
were  obstructions  to  free  currents  of  air,  from  the  eastern  and 
southern  quarters.  From  these  points,  the  wind  blows  four  fifths 
of  the  time,  during  the  summer  months. 

One  of  the  efficient  cau?e»  of  the  sickness  at  Fort  George, 


■   ! 


■7^ 


T 


II 


i  i 


|i| 


i; 


i  1 


60 


MEDICAL  SKETCHES. 


aesigned  by  myself  at  that  time,  was  the  eflluvin  from  the  suiks. 
This  evil  was  reported  by  myself  to  General  Boyd  ;  on  whom 
devolved  the  command  of  the  army,  after  General  Dearborn 
was  ordered  to  tlie  eastern  district.  The  General  repeatedly 
called  the  attention  of  the  officers  commanding  corps,  to  the  im- 
portant necessity  of  daily  covering  the  sinks  with  earth.  Nev- 
ertheless, the  exhalations  from  them  to  me,  who  occasionally 
visited  the  post,  were  very  offensive  ;  while  no  unpleasant  odour 
was  noticed,  or  complained  of  by  those  of  the  army,  who  were, 
continually  exposed  to  the  offensive  gasses  emanating  from 
these  reservoirs  of  fdth.  ,  i     " 

This  fact  is  one  evidence  among  many,  of  the  force  of  hab- 
its. In  this  instance,  the  faculty  of  smelling  was  so  blunted  by 
ibe  impure  exhalations,  that  it  became  insensi!)le  to  their  influ- 
ence ;  so  as  the  constitution  was  imperceptibly  impaired,  and  a 
predisposition  to  disease  induced,  before  the  patient  was  con- 
scious of  the  cause. 

During  the  month  of  August,  an  uncommon  proportion  of  the 
army  were  sick,  or  unfit  for  duty.     More  ihan  one  third  of  the 
soldiers  were  on  the  sick  reports.     The  officers  shared  with  the 
privates,  in  the  prevailing  diseases.     Half  of  the  medical  staff 
attached  to  regiments,  were  also  unable  to  perform  their  duty. 
Of  seven  surgeon's  mates  attached  to  the  hospital  department, 
one  died,  and  three  had  leave  of  absence,  by  reason  of  indispo- 
sition ;  the  other  three  were,  for  a  short  period,  sick.     So  gen- 
«ral  was  the  sickness,  the  few  remaining  surgeons  could  not  do 
full  justice  to  their  patients.     At  the  time  when  the  returns  of 
the  sick  in  the  general  hospital,  counted  between  six  and  seven 
hundred,  there  were  only  three  surgeons  of  this  department, 
present  for  duty.     At  this  period  of  General  Boyd's  command, 
the  troops  were  under  excellent  discipline,  the  encampment  in 
;ood  condition,  and  the  men  neat  in  their  apparel.     The  gen- 
eral and  regimental  hospitals  were  reported  during  the  summer 
irro'.tbs,  by  the  inspectors  of  the  army,  "  in  the  best  possible 
order." 

Doctor  LevKLL,  hospital  surgeon,  (late   surgeon  of  the  Otii 
regiment  of  Infantry,)  who  was  attached  to  the  army  at  Fort 


CAMPAIGN  OF  1813. 


07 


George,  thus  observes,  "  the  division  of  tlie  army  stationed  at 
Fort  George,  from  the  beginning  of  June,  U  the  beginning  of 
October,  1813,  was  encamped  on  the  l>ank  o»  ihe  Niagara,  ex- 
tending from  the  fort  to  the  village,  nearly  on  the  lake  shore. 
The  surrounding  country  is  flat,  and  the  cnmp  vras  deprived  of 
the  benefit  of  the  lake  breezes,  from  the  position  of  Newark. 
During  the  month  of  June,  it  rained  almost  incessantly  ;  while 
Ihe  latter  part  of  July,  and  the  whole  of  August,  were  extremely 
hot;  the  whole  of  September  however,  was  remarkably  mild 
and  pleasant.  Thus  after  having  been  wet  for  nearly  a  month, 
the  troops  were  exposed  for  six  or  seven  weeks  to  intense  heat 
ilurinjr  the  day,  and  at  night,  to  a  cold  and  chilly  atmosphere, 
in  consequence  of  the  fog  arising  from  the  lake  and  river.  Tlie 
enemies'  advance  being  within  a  short  distance  of  the  camp,  the 
details  for  duty  were  large,  and  skirmishes  taking  place  at  the 
piquets  every  morning  ;  the  soldiers  were,  for  a  length  of  time, 
stationed  at  the  several  works,  for  several  hours  before  day-light ; 
and  thus  exposed  to  the  effects  of  a  cold  damp  atmosphere,  at 
the  time  the  system  is  most  susceptible  of  morbid  impressions. 
The  diseases  consequent  to  this  alternate  exposure  to  a  dry,  hot, 
and  cold  damp  atmosphere,  were  such  as  might  have  been  ex- 
pected ;  typhous  and  intermittent  fevers,  diarrhoea  and  dysente- 
ry. A  detachment  of  artillery,  stationed  at  the  right  wing  near 
the  lake,  was  particularly  exposed  to  the  heat  of  the  day,  and 
dampness  of  the  night,  and  sutfered  much  from  typhus  and  in- 
termitteuls.  I  do  not  recollect  a  single  instance,  in  which  ty- 
phus came  on  with  a  sudden  and  complete  paroxism.  It  at- 
tacked in  a  slow  and  insidious  manner,  which  almost  invariably 
denotes  an  obstinate  and  long  continued  fever ;  and  in  which 
we  are  seldom  to  expect  a  crisis.  The  symptoms  were  those, 
denominated  typhus  gravior ;  although  severe,  they  were  gen- 
erally regular.  In  some  cases  however,  delirium  came  on  very 
early,  and  was  much  more  severe  than  the  other  symptoms.  1( 
was  of  that  species,  attended  with  an  obvious  increase  of  arterial 
action  in  the  brain ;  and  relieved  by  the  application  of  cold,  or 
blisters  to  the  part  effected.  The  disease  began  to  subside  about 
the  fourteenth  day,  and  gradually  disappeared  during  the  third 


i] 


u 


u 


-!l' 


I': 


n 


1     5 


I 


tf8 


MEDICAL  SKETCHEH. 


week  ;  but  in  some  cases,  no  symptoms  of  recovery  were  to  be 
noticed,  until  the  end  of  the  third  week." 

"  The  treatment  adopted  was,  with  a  few  variations,  that  rec- 
ommended by  FoRUTCE,  in  his  dissertations  of  fever,  and  the 
success  was  complete ;  not  one  case  of  death  occurring  of  this 
complaint,  in  the  corps  to  which  I  was  attached." 

"  The  cases  of  intermittents  were  numerous,  and  generally  of 
the  tertian  type ;  not  however  very  obstinate.  The  remedies 
employed  were  emetics,  opium,  bark,  and  Fowler's  solution. 
Opium,  and  particularly  bark,  had  not  a  very  good  effect.  I  was 
particularly  unsuccessful  with  the  latter ;  whereas,  the  mineral 
solution  universally  succeeded,  both  in  those  cases,  where  other 
medicines  had  failed,  and  those  where  it  was  used  alone.  I 
shall  have  occasion  to  observe  the  contrary  effects  of  the  medi- 
cines, during  the  campaign  on  this  frontier,  in  1814.  That  this 
Avas  not  owiiig  to  the  quality  of  the  medicine,  would  appear  evi- 
dent from  their  having  been  procured  from  different  places,  and 
not  shewing  any  defect  of  power  in  other  com[)laint3." 

"  These  diseases,  however,  though  severe,  bore  but  a  small 
proportion  to  the  usual  pestilences  of  our  army,  diarrhoea,  and 
dysentery.  During  two  years  and  a  half,  I  was  on  the  frontiers, 
at  every  post  from  Buffalo  to  Burlington,  Vermont,  these  com* 
plaints  almost  invariably  absorbed  all  others.  They  were  the 
only  ones  which  could  be  called  our  camp  diseases.  All  others 
arose  from  obvious  or  local  causes,  and  were  as  common  to  the 
citizen  as  the  soldier." 

"  By  dysentery,  is  not  meant  that  idiopathic  form  of  disease 
described  in  books,  as  an  almost  invariably  attendant  on  a  camp ; 
for  during  the  whole  war,  I  saw  idiopathic  dysentery  but  once ; 
and  then  it  was  contincd  to  the  militia  under  General  Porter, 
in  the  latter  part  of  1814.  The  complaint  above  referred  to, 
consisted  simply  of  dysenteric  symptoms,  consequent  upon  the 
violence  or  long  continuance  of  simple  diarrhoea.  The  two 
complaints  would  sometimes  alternate  very  early  ;  but  the  symp- 
toms of  dysentery  were  easily  removed  at  this  period,  by  the 
simplest  means.  After  the  diarrhoea  had  continued  several 
weeks  or  mouths,  the  mucous  coat  of  the  rectum  became  inflamed, 


■11 


CAMPAIGN  OF  1813. 


99' 


fn  consequence  of  perpetual  irritation;  and  tinally,  ulceration 
tooli  place,  aa  appeareil  on  dissection.  Tliout^b  the  rectum  was 
the  part  principally  affected,  in  many  cases,  (he  whole  intestinal 
canal  bore  marks  of  inl1;imm;ition  ;  being  covered  with  large 
spots  of  a  dark  or  livl<l  a|)pearance  ;  and  sometimes,  spots  of  ef- 
fused lymph  were  foumi  in  the  mucus  coat  of  the  ileum.  Cases 
of  this  natuie  were  probably  often  relieved  by  the  applica- 
tiou  of  blisters,  or  poultices  to  the  abilomen,  as  will  be  presently 
mentioned.  The  inflammatory  a|)pearance8  after  death,  how- 
ever, were  not  so  remarkable  as  might  have  been  expected 
from  the  symptoms  during  life." 

"  In  its  incipient  stage,  diarrhoea  was  easily  cured  by  evacuaf 
tions,  followed  by  opiates  and  astringients  ;  but  after  having  con* 
tinued  some  time,  it  was  ;»ccompanied  with  severe  febrile  symp- 
toms; a  contracted  wiry  pulse  ;  tongue  perfectly  dry,  and  cov- 
«red  with  a  dark  brown  or  black  fur;  or  of  a  dark  colour,  and  as 
if  glazed ;   skin  extremely   dry   and   scaly.     The   emaciation 
equal  or  surpassed  what  occurs  in  any  other  disease.     The  dys- 
enteric symptoms  being  kept  up  by  the  continual  irritation  of  the 
diarrhoea,  could  oidy  be  relieved  by  anodyne  and  emolient  in- 
jections, and  mucilaginous   food.     AH  attempts  to  check  the  di- 
arrhoea  by  opiates  and  astringents  were  immediately  followed 
by  an  increase  of  febrile  affection.     They  (the  above  medicines) 
had  but  a  temporary  effect  on  the  diarrhoea,  and  if  persisted  in^ 
speedily  destroyed  the  patient.     Antacids,  and  particularly  lime 
water,  often  had  a  very  goo<l  but  tem|)orary  effect.     The  only 
medicine,  in  fact,  that  I  found  generally  to  have  beneficial  ef- 
fects, was  ipecacuanha.     When  the  state  of  the  stomach,  tongue 
and  skin  indicated  it,  a  gentle  emetic  of  ipecacuanha  had  a  most 
beneficial   effect,  and  often  laid  the  foundation  for  a  cure.     At 
other  times,  doses  of  from  two  to  three  grains  often  repeated,  so 
as  to  produce  catharsis,  gave  speedy  and  permanent  relief;  and 
very  many  were  restored  to  health  by  small  doses,  for  a  length  of 
time  combined  with  opium,  or  in  the  form  of  Dover's  powder.** 
"  The  only  cathartic  I  found  beneficia?,  at  this  period,  wag 
01.  Ricini,  which  generally  produced  an  alteration  of  the  symp- 
toms for  several  days.     The  application  of  a  large  blister  to  the 
10 


1 


h 


i*      i 


'■•    i 


r« 


MEDICAL  SKETCHES. 


11 


Hi 


•B 


ji 

hi 


i 


abdomen'  would  ortoii  have  the  same  eflVct.  But  it  wat  diffi- 
cult to  determine  a  priori,  whether  it  would  produce  this  eflect 
or  not;  for  the  relief  wns  not  in  proportion  to  the  dysenteric 
symptoms.  It  appeared  from  some  dissections,  that  this  result 
took  place,  in  those  cases,  where  the  small  intestines  were  prin- 
cipally inflamed;  upon  such  patients,  mild  and  mucilaginous 
food  was  found  beneficial.  Very  great  relief  was  also  obtained 
by  the  application  of  a  poultice  of  the  inner  bark  of  the  slippery 
elm,  to  the  whole  abdomen.  After  obtaining  a  truce  with  the 
complaint  by  one  of  these  means,  the  cure  was  effected  by  small 
doses  of  ipecacuanha,  or  of  Dovers'  |>owder,  continued  for  a 
long  time,  repeating  the  remedy  first  used,  as  occasion  required. 
This  was  the  only  treatment  that  appeared  to  be  generally  at- 
tended with  any  success.  It  should  be  added,  however,  that 
many  who  had  so  far  recovered,  as  to  be  reported  fit  for  light 
duty,  would  be  taken  with  so  violent  a  relapse,  as  to  sink  in  one 
night ;  while  others  would  die  suddenly,  without  any  adequate 
cause  discoverable,  either  before  or  after  death. 

"During  the  whole  of  October,  and  part  of  November,  most  of 
t)ie  troops  were  exposed  to  excessive  fatigue,  and  almost  inces- 
•ant  rains,  in  open  boats  on  the  lake.  On  their  arrival  at  the 
French  mills,  about  the  14th  of  November,  the  weather  became 
intensely  cold,  and  remained  so  during  the  winter  months." 

Typhous  fever,  dysentery,  diarrhoea,  and  these  variously  com- 
bined were  the  prevailing  '<seases,  during  the  months  of  May, 
June,  July,  and  August.  Intermittent  and  synochal  fevers  ajv 
peared  in  the  months  of  September  and  October.  But  dysente- 
ry and  diarrhoea  were  the  most  general  diseases  through  the 
summer  months,  and  they  continued  into  autumn.  The  last 
form  of  these  diseases  was  the  most  obstinate.  These  com- 
plaints of  the  bowels  were  not  confined  to  the  tented  field ; 
ni'ilber  were  typhous,  synochal,  and  intermittent  fevers.  They 
did  not  a|)pear,  however,  with  all  those  severe  and  aggravated 
symptoms  among  citizens,  as  in  the  army.  Hence  an  inference 
was  drawn,  that  as  the  citizens  were  8ul>jected  to  the  above 
forms  of  disease;  their  causes  were,  but  in  part,  connected  with 
the  life  and  habits  of  a  soldier ;  or  the  casualties  to  which  he 


TT 


CAMPAIGN  OP  1813. 


71 


trns  unavoidflhiy  exposed.  Tlirse  disrases  were  consequently 
eonsldered  endemic,  on  the  Niapnra  frontier,  and  excited  l>y 
additional  causes,  than  those  uhich  depended  on  local  situation, 
vicrc  most  severe  among  the  troops.  The  bowel  complaints, 
among  the  inhabitants,  were  supposed  by  them,  to  have  been 
produced  by  the  water  on  that  frontier.  It  was  the  sentiment 
of  the  first  settlers,  that  the  water  possossrs  a  purgative  quality. 
This  opinion  w  s  current  also  in  the  army.  The  citizens  stat- 
ed, that  the  new  settlers  were  always  attacked  with  these  disor- 
ders of  the  bowels,  the  first  summer  after  their  arrival ;  and  that 
but  few  escaped  them.  Lime-stone,  or  calcareous  rock,  a  snh- 
stratum  of  the  enrth  in  the  viciiiily  of  Ontario,  which  the  waters 
hold  in  a  state  of  solution,  was  conjectured  by  some,  a  cause  of 
th«se  complaints  of  the  bowels.  A  more  probalde  cause  of  these 
endemic  diseases  is,  in  my  opinion,  the  proiiuction  of  vegetable 
putrefaction ;  with  which  the  springs,  rivulets,  large  rivers,  and 
the  waters  of  Ontario,  are  impregnated  during  the  summer  and 
autumnal  months.  The  clearing  the  lands  of  their  forests,  and 
cultivation  of  the  soil,  by  producing  earlier  evaporations  of  wa-i 
ters  from  their  surface,  before  the  heat  of  the  summer  is  so  high 
in  degree,  as  to  produce  a  putrefactive  process  u|)on  vegetable 
substances,  in  a  state  of  decay,  will  obviate  these  complaints  of 
the  bowels,  and  likewise  those  autumnal  fevers,  to  which  the 
inhabitants  are  subjected.  * 

The  intermittents  and  synochal  forms  of  disease,  which  su- 
pervened during  the  months  of  September  and  October,  were 
more  immediately  under  the  control  of  remedies,  than  typhus, 
diarrhoea,  and  dysentery.  The  first  forms  of  disease  appeared 
among  several  officers,  who  were  permitted  to  leave  the  encamp- 
ment at  Fort  George,  soon  after  they  were  indisposed.  Where- 
as, the  privates  were  generally  attended  by  their  own  surgeons, 
in  the  regimental  hospitals,  and  were  seldom  removed  to  the 
flying  hospital,  until  their  diseases  had  progressed  to  the  last 
stage. 

These  synochal  fevers  were  accompanied  with  pain  in  the 
head,  increased  :^eat,  fullness  and  hardness  of  the  pulse  ;  all  of 
which  indicated  an  excess  of  excitemeDt,    which  demanded 


t    ,! 


U: 


1 


'Mi''' 


!'^'!   ' 


ilii 


72 


MEDICAL  8KETCHEH. 


bleeding,  and  an  antiphlogistic  r(>(;iin(!ii.  In  niuRt  canet,  wliicb 
fell  under  my  uliservation,  hluod-lcttinc;  to  the  i{ii;iiitily  of  Hixleeu 
ounceB,  a  cutlmrtic  of  cnloin<;l  nnd  .iHliip,  removed  the  exeees  of 
excilrmenl,  and  placed  the  pittieiit  in  n  condition,  in  which  an- 
timonials  in  smull  doscfl,  removed  the  rem:  i.ia  of  d'scuHed  uctioii. 
Aijout  the  same  period,  a  case  called  my  attention,  which  had 
been  of  some  duration,  periiapa  twelve  or  fourteen  days.  What 
the  symptonnt  were,  at  the  first  onset  of  the  disease,  I  did  not 
leom.  This  patient  was  extremely  debilitated,  when  he  waB 
removed  to  the  flyinc;  hospital  encampment.  At  this  period,  the 
puiso  was  contracted,  (pjick  and  hard;  the  skin  dry,  and  cool  in 
the  mornings,  but  hot  in  the  eveninps.  These  symptoms  were 
attended  with  delirium.  Some  infl  immalion  on  the  ey<  s  indi- 
cated an  excess  of  excitement  on  the  brain,  as  did  the  other 
eymptoms,  especially  delirium.  A  blister  was  applied  upon  the 
neck  ;  one  grain  of  calomel  niji;hl  and  morning,  and  one  fourth 
of  a  grain  of  tartrite  ef  antimony,  every  four  hours,  were  pre- 
scribed. The  delirium  coniinued  with  watchl'iduess  ;  the  above 
medicines  Mere  directed  the  second  and  third  day.  The  disease 
remained  in  statu  quo.  The  bark  and  wine  were  proposed  liy  a 
surgeon  of  the  army.  The  experiment  was  acceded  to  by  my- 
self, but  not  with  a  high  degree  of  confidence.  As  had  been 
anticipated,  the  before  mentioned  febrile  symptoms  were  all  ag- 
gravated ;  while  the  remissions  were  shortened,  and  the  fever 
assumed  a  more  continued  form.  A  cathartic  was  then  admin- 
istered, the  antimonials  in  small  doses  were  again  resorted  to, 
and  were  continued.  The  paroxisms  of  fever,  under  this  last 
process,  daily  lessened,  and  gradually  disappeared,  with  an 
abatement  of  delirium,  and  a  return  of  appetite. 

This  is  one  case  among  many,  which  might  be  recorded, 
where  the  bark  and  wine  have  been  injudiciously  administered, 
within  my  own  observation.  The  |)Mctice  of  administering  bark, 
during  remissions  of  fever,  is  in  conformity  to  that  of  Cii^lkn. 
Long  experience  has  convinced  me,  that  the  practice  of  intro- 
ducing bark  and  wine,  as  soon  as  there  is  a  remission  of  fever, 
will  not  generally  succeed  in  the  autumnal  .mixed  fevers,  as 
they  appear  in  the  eastern  and  uortheru  states.     After  there  is 


CAMPAIGN  OF  1818. 


a  complete  reBolulion  of  fever,  Ihi'se  remediog  nre  proper,  Bome* 
times  iiHlispciiHililc  to  give  tune  to  tlie  slomacli,  aud  excite  the 
organs  subservient  tu  digestion  into  action. 

Summary  of  the  counts  which  were  helvurd  to  he  active  in  the  pro* 
duciion  of  the  various  diseases  oil  the  Niagara,  during  the  cantf 
paign  tf/*  1813. 

IsT.    Pnr.DISPONF.WT. 

The  debilitating  eflVcIs  of  the  e|.idemic  of  the  preceding 
winter.  From  these  tlie  soldiers  hnd  not  fully  recovered,  liefore 
they  were  subjected  to  severe  duty,  during  inclement  weather 
in  the  month  of  March,  when  on  their  routes  from  the  interior  to 
the  frontiers,  and  exposures  on  the  lake  in  open  transports,  as 
well  as  in  the  field. 

2d.  hurtfttl  agents. 
These  acted  as  both  [tredisjtonent  and  exciting  causes,  and 
generally  mi^ht  have  been  obviated. 

1.  Bad  bread.  It  wns  notorious  that  the  bread  on  the  Niagara 
was  made  of  damnged  flour  ;  such  as  was  either  not  nutritious,  or 
cihsolutely  deleterious.  It  was  also  believed,  that  the  flour  conr 
tained  in  some  instances  an  earthy  substance,  and  that  this  ad- 
ulterating substance  was  plaster  of  Paris  (gypsum.) 

2.  Bad  water,  impregnated  with  the  |)roduction  of  vegetable 
putrefaction,  more  or  less  active  in  producing  the  endemic  dis- 
eases of  the  country. 

3.  TJu  cjffluviafrom  the  sinks,  materials  of  animal  production* 
with  which  the  circumambient  air  was  replete.  This  evil  might 
have  been  remedied  by  a  rigid  police,  and  more  thorough  cover- 
ing of  the  sinks,  or  by  a  change  of  position,  a  distance  of  one  or 
two  hundred  yards. 

3o.    EXCITEMENTS. 

As  more  immediate  causes, 

1.  Heat  and  cold,  alternating  with  each  other,  and  inducing  m 
the  system  unequal  excitement.  Both  these  powers  were  more 
active  in  producing  their  deleterious  effects,  when  combined 


li 


•^k 


^   ii 


i 


r 


If  I 


m^ 


74 


MEDICAL  SKETCHES. 


lR?ith  molsttire,  In  thn  form  of  raina,  fopj-,  nml  tirwg.  Thr  rffpcU 
of  hoitt  nnil  cold  miglit  have  beun  in  somu  decree  obviated,  by 
woolen  K!irin(>nta. 

a.  Falii^tiffi  of  body,  and  severe  hardships,  comprising  tlie  whole 
routine  of  duly,  botli  by  dny  and  night.  These  >vero  unavoida- 
ble. 

3.  Inebriation.  Tlie  cffrclB  of  ardent  splriln  were  Imlh  pre* 
(liBponent,  and  immediate.  Tlic«e,  when  received  into  the  atom* 
och  in  undue  ()uantilieB,  induced  on  (he  brain  endorsement;  or 
when  they  were  repeatedly  drank  to  nn  excess  alwrt  of  absolute 
intoxication,  general  deliility.  These  last  agents  were  more  ac- 
tive in  the  production  of  violent  diseases,  than  many  of  tiie  oth' 
er  deleterious  |)ower8  combined.  " 

The  several  causes  above  enumerated,  will  suggest,  at  first 
view,  the  forms  of  disease  which  occur  to  those  exposed  to  their 
inlhienccB,  or  subjected  to  their  agency. 

It  is  to  be  observed,  few  recent  causes  of  either  diarrhoea,  dys- 
entery or  typhous  fever  fell  under  our  observation  in  hospital 
practice.  As  we  are  giving  skelches  of  diseases  as  they  appear- 
ed to  lis,  it  must  not  be  exjiected,  that  these  will  be  detailed 
from  their  commencement,  throu.i^h  all  their  several  stages,  in  a 
Bystematic  order.  The  practical  physician  must  not  look  for 
new  theories,  nor  will  he  be  instructed  by  many  practical  ol)ser- 
vations,  which  are  not  to  be  met  with  in  books  found  in  the  li- 
hrary  of  every  medical  man. 

The  olyect  here  intended  is  to  exhibit  what  was  done  in  cer- 
tain slates  of  disease,  and  under  certain  circumstances ;  not  what 
should  have  been  directed  to  the  patient,  under  different  states 
and  circumstances.  It  must  l)e  remembered,  the  means  of  af- 
fording relief  to  the  distressed  in  an  army  are  few,  compared 
wi^h  those  which  jjrescnt  themselves  in  domestic  practice. 

The  patients,  generally  ordered  to  our  hospitals,  were  such  as 
had  been  unsuccessfully  treated  by  the  fegimental  surgeons  in 
camp,  where  the  accommodations  were  less  eligible  than  in  tb*' 
hospitals,  with  all  their  defects.  Flying  hospitals  attached  to  au 
army,  from  their  instability,  cannot  be  expected  to  be  in  the 
highest  possible  order.    It  is  the  work  of  months  and  persevering 


CATVrPAinW  OP  1813. 


f5 


Uhow,  ns  well  as  itiireinittcd  attention,  to  render  two  hundred 
untients  very  comfortuhlu  in  a  permiiiient  liospita!.  But  when 
the  number  is  increased  to  five  hundrc<l  or  one  thousand  |)atient8, 
under  one  estahlishment,  (and  such  has  been  the  sicknes  in  thu 
army,  as  tluis  to  gorge  the  hos|)itulH)  the  duty  vvliich  devolved 
on  the  surgeons  was  severe  beyond  calculation.  It  may  be  a 
question,  whether  it  is  better  policy  to  detain  the  sick  with  their 
regiment,  until  they  are  reduced  to  the  last  extremity  by  dis- 
ease, or  order  them  to  the  hospital  at  an  earlier  perioil. 

Those  jiatienls  only  were  ortlered  to  the  general  hospital,  who 
had  been  long  unsuccessfully  treated  by  the  regimental  surgeons 
in  camp.  Consequently  the  cases  admitted  were  either  chronic, 
or  in  the  last  stages  of  their  disease,  many  of  which  were  most 
ol)slinate,  or  irremediable.  These  patients  had  already  pass,  d 
thro'  the  usual  routine  of  emetics  and  cathartics,  and  were  found 
in  bad  condition,  with  their  skin  scaly,  dry,  and  cold;  pulso 
quick  and  weak  ;  total  loss  of  a|)petite ;  stomachs  nauseated 
with  every  species  of  nutriment,  and  extremely  debilitated; 
such  were  the  states  of  those  who  were  alllicted  with  diarrhoeris, 
and  dysenteric  symjitoms.  The  indications  were  to  excite  the 
stomach  to  action,  liy  grateful  stimulants ;  wine,  diluted  spirits, 
spices.  To  restrain  profuse  evacuations,  by  opium,  or  by  med- 
cine  possessing  more  permanent  restrictive  powers.  With  this 
last  intention  Moseley's  vitriolic  mixture  was  prescrif)ed  ;  not, 
however,  with  all  the  benefit  wished  for,  or  expected.  For  the 
same  purpose  astringents  of  many  kinds  were  tried  in  vain.  Hav^ 
iug  been  informed  by  some  regimental  surgeons,  that  they  had 
experienced  success  in  the  removal  of  these  diaeasus  by  acetite 
of  lead,  experiments  were  made  in  hospital  practice  also  with 
tills  medicince,  but  not  succeeding  immediately  with  it,  we  de- 
sisted from  its  use  as  an  internal  remedy.  Of  strong  prejudices 
early  ac(](uired  we  could  not  divest  ourselves  ;  and  later  experi- 
ence has  convinced  us,  this  drug  has  been  frequently  administer' 
ed  for  these  complaints  of  the  bowels  with  too  little  caution. 

In  most  obstinate  chronic  diarrhoea,  the  following  preparation 
wag  administered  with  more  success  than  any  other  astringent 
remeily.     To  two  quarts  of  strong  decoction  of  white  oak  bark*. 


u 


I         \ 


"   ; 


ii; 


4i 
1  / 


ii^ 


i" 


;i';,ll 


10 


MEDICAL  SKETCHES. 


tva«  added  one  ounce  oliiiuin  in  pow«Ier,  and  one  quart  of  hrafiii» 
dy.  A  table  apoout'ul  of  this  mixture  wng  administered  once  in 
three  or  four  hours  ;  one  grain  of  opium  occasionaliy,  moet  gen- 
erally at  night.  This  uslring(Mit  stimulus  was  inadmissible 
Inhere  fever  existed.  U  was  resorted  to  where  the  patient  was 
reduced,  and  the  evacuations  from  the  bowcis  profuse.  The 
above  formula  was  introduced  into  hos.titul  practice  by  Doctor 
WniTRiocr,  hospital  surgeon's  mate  on  the  Niagara 

Persuaded  as  I  was,  that  these  oltstinate  diarrhoeas  required 
a  long  course  of  diaphoretic  medicine  to  remove  them;  recourse 
was  had  to  Dover's  powders.  In  this  preparation  we  possess 
the  restrictive  powers  of  opium,  and  the  diaphoretic  property  of 
ipecacuanha  combined.  This  medicine,  when  the  patient  was 
confined  to  his  bed  between  blankets,  wag  pro<luctive  of  happy 
eflccts.  To  those  who  were  able  to  walk,  it  was  prescribed 
without  great  precaution.  Patients  labouring  under  chronic  di- 
arrhoea took  this  medicine,  when  unavoidably  exposed  to  transi- 
tions of  weather,  without  any  increased  inconvenience.  In  most 
obstinate  cases  its  beneficial  effect",  were  slow,  but  i>ermanent ; 
although  the  obstinacy  of  the  disease  was  very  discouraging,  yet 
by  perseverance,  it  was  in  most  cases  overcome.  In  cases  where 
nausea  indicated  an  emetic,  ipecacuanhas  were  preferred  to  any 
other,  and  where  cathartics  were  demanded  to  obviate  tenes- 
mal  irritation,  .nanna  and  cream,  tart,  combined  in  solution,  or 
ol  ricini,  were  the  most  suitable.  To  remove  pain,  the  conse- 
quence of  chronic  inflammation  on  the  mucaus  coats  of  the  intes- 
tines, blisters  sometimes  acted  as  a  counter  stimulus,  and  gave  re- 
lief. !n  all  cases  the  patients  were  put  on  a  soft  nutritious  diet. 
No  article  prescribed  proved  so  beneficial  as  milk  and  its  prep- 
arations. It  was  most  grateful  to  the  |)atienls;  it  was  an  article 
they  could  take,  when  other  kinds  of  food  were  rejected.  By 
milk  alone,  it  was  iny  persu;*.bion,  that  many  lives  were  saved, 
which,  without  it,  would  have  been  lost.  I  have  been  highly 
gratified,  as  well  as  astonished,  to  sec?  with  what  avidity  m  Ik 
was  devoured  by  those  enfeebled  by  diseases,  who  had  not  been 
accustomed  to  it  whe;?  in  health.  These  patients  were  dnily  in- 
djlged,  also,  vith  wine  or  diluted  spirits,  in  moderate  quanti- 
ties. 


CAMPAIGN  OP  1313. 


ft 


During  Ihe  month  of  May  a  number  of  patients  were  admitted 
into  the  hospital,  from  those  regiments  who  had  been  previously 
<?mployeil  on  the  expedition  to  Little  York.  It  has  l)een  al- 
ready observed,  tiie  troops,  previous  to  their  (^mbarltatiou  at 
Sacketl's  Harliour,  had  been  long  ex|)08ed  to  fatiguing  marches, 
during  the  severe  cold  and  ANet  month  of  March.  On  their  pas- 
auge  up  the  lake  on  board  the  transports,  they  were  not  covered 
from  the  weather:  after  the  reduction  of  that  post  in  Upper  Can- 
ada, they  were  sorJted  with  rains  for  several  <lays  on  board  the 
fleet.  Many  of  these,  soon  after  debarkation  on  the  Niagara, 
were  taken  down  with  typhous  fever.  Their  first  indispositions 
were  scarcely  attended  to  by  themselves.  At  first  (here  was 
dyspepsia,  heaviness  in  the  head,  accompanied  with  dizziness, 
without  any  evident  regular  paroxisms  of  fever.  These  symp- 
toms daily  increased,  until  the  patient  complained  of  weakness, 
without  being  able  to  assign  any  particular  cause.  The  above 
symptoms  progressing  were  attended  also  with  lassitude,  mental 
depression,  and  soreness  throughout  the  muscles  of  the  body. 
Then  followed  watchfulness,  or  interrupteu  sleep,  reveries,  false 
imaginations,  confusion  of  thought,  a  dull  pain  in  the  head  and 
down  ihe  dorsal  muscles,  intervals  of  mental  derangement,  tor- 
por and  low  delirium.  The  above  symptoms  progressed  so  slow 
from  day  to  day,  the  change  was  scarcely  perceptible. 

During  the  progress  of  the  above  symptoms,  a  small  increase 
of  heat  was  noticed  with  but  little  alteration  in  the  pulse,  except 
it  was  somewhat  accelerated. 

When  the  first  symptoms  of  dyspepsia  and  heaviness  were  at- 
tended to,  an  emetic  of  tartrite  of  antimony,  or  ipecacuanha,  in- 
terrupted the  chain  of  diseased  actions,  and  if  followed  by  a  ca- 
thartic, obviated  the  succeeding  symptoms,  i  .id  arrested  their 
course.  When  a  soft  nutriment,  as  soups,  and  wine  in  noderate 
quantity,  effected  a  restoration. 

It  was  too  frequently  the  case,  that  the  surgeons  had  not  an 
opportunity'  to  effect  the  above  favorable  termination  of  the  first 
indisposition.  Either  the  patient  neglected  to  apply,  as  soon  a» 
the  first  complaint  commenced,  or  his  continued  exposure  to  those 
causes  which  induced  a  predisposition,  obvi'   *d  Ihose  salutar/ 

n 


1       ; 

1 

if 

•I' 


19 


MEDICAL  SKETCHES. 


i  S. 


^n' 


■  n 


li.i 


I  u 

rl 


m 


effects  of  emetics  and  cathartics  which  might  have  hocn  expect- 
ed, had  he  beca  placed  under  circuinstunceH  more  favorable  to 
health. 

W  hen  the  patient  was  found  laboring  under  the  whole,  or  many 
cf  the  above  nnfavorable  symptoms,  the  disease,  although  insidi- 
ous at  first,  no  longer  left  us  in  doubt  ns  to  its  nature.  Its  fea- 
tures were  more  strongly  delineated  by  a  dry  skin,  with  an  inr 
crease  of  heat;  dry  tongue  with  a  brown  incrustation  ;  pains  in 
the  head  and  l)ack  ;  and  soreness  in  the  muscles  ;  watchings  in 
the  first  stages  ;  stupor  and  delirium  in  the  last. 

Emetics  and  cathartics  were  indicated  to  remove  irritation 
from  the  first  passages,  aftev  which  the  following  prescription 
was  administered  with  benefit:  R.  Cal.  gr.  10.  Opium,  gr.  5. 
Tartrile  antini.  gr.  1.  M.  fiant  Pilluln;,  10.  of  which  the  pa- 
tient look  one  every  fourth  hour,  and  intermediately  the  Vinum 
antimon.  in  nauseating  do^es  to  jjrocure  a  disaphoresis.  But 
wben  *  this  disease  was  accompanied  with  diarrhoea,  a  dose  of  5 
to  10  grains  of  Dover's  powder  was  substituted  for  the  medicine 
last  mentioned.  When  the  typhous  symptoms  of  disease  were 
accompanied  with  tenesmal  diarrhoea,  indicating  irritation  and 
inflammation  on  some  portion  of  the  intestinal  canal ;  a  cathar- 
tic of  jalap  and  calorriel,  or  rhubarb  and  cal.  or  castor  oil  were 
found  necessary  ;  after  which  oi»ium  and  mucilaginous  injections. 
After  a  resolution  of  fever,  known  by  a  moist  tongue,  moist  and 
soft  skin,  natural  sleep,  a  return  of  some  appetite,  the  following 
were  adrainistered  :  R.  Spt.  Nit.  dulcis  oz.  1.  Aqua,  ammon. 
oz.  2.  A  tea  spoonful  of  the  above  mixture  was  administered 
every  two  hours.  Or  spirit  of  lavend  comp.  or  tinct.  cort.  comp. 
or  a  decoction  of  snake  root  or  bark.  Wiue,  during  this  state, 
became  an  important  remedy. 

During  the  course  of  the  fever,  a  blister  on  the  neck  or  head, 
or  on  various  parts  successively,  was  sometimes  found  necessary 
to  counteract  local  pains,  and  equalise  excitement. 

The  above  remedies  were  more  certainly  etficacious,  when 
the  patient  was  placed  in  a  situation  wherein  cold  and  moisture 
did  not  operate  upon  the  body,  so  as  to  counteract  a  gentle  di- 
aphoresis.    The  nutriment  was  adapted  to  the  state  of  the  stora- 


CAMPAIGN  OF  1813. 


va 


acli.     There  was  a  period  of  this  disease,  previous  to  its  com- 
plete resolution,  and  where  the  powers  of  life  seem  to  be  on  the 
point  of  yielding  to  the  insidious  etfects  of  its  hurtful  agents, 
that  wine  alone  l)ecame  the  most  appropriate  remedy.      This 
state  was  better  known  than  can  be  described,  even  by  the  dis- 
criminating physician.  i,;     ..,■    .nr-f.   .   i 
During  the  summer  months,  the  typhoid  symptoms  of  fever 
were  so  intimately  combined  with  the  dysenteric  and  diarrhoea, 
it  was  not  easy  to  discriminate  between  the  two  forms  of  disease. 
These  complaints  were  considered  varieties  of  one  and  the  same 
disease,  depending  on  the  same  general  causes  for  their  existence, 
and  required  but  a  little  variation  in  their  treatment.      There 
were  but  a  few  instances  of  diarrhoea,  unaccompanied  with  more 
or  less  febrile  action,  in  some  one  of  its  stages;  as  there  were  no 
instances  of  typhus,  in  which  diarrhoea  or  dysenteric  symptoms 
did  not  form  a  part  of  the  disease.      Tlie  general  remedies  were 
the  same  ;  some  regard  being  had  to  the  j)revalent  forms  of  the 
disease.     Those  patients,  who  had  been  reduced  by  disease,  qir 
the  various  means  employed  previous  to  their  admission  into  the 
hospital,  required,  in  most  casch    opium,  wine,  soft  nutriment, 
comfortable  lodgings,  cleanliness  from  dirt  and  vermin.      Some 
few  were  afflicted  with  the  last.    A  patient  was  admitted,  whose 
clothes  were  not  only  dirty  in  the  extreme,  but  had  become  hab- 
itations for  armies  of  lice  ;  his  hair  was  also  tilled  with  this  tribe 
of  insects.     He  was  cleansed  by  tlxe  removal  of  his  dirty  linnen, 
and  the  hair  from  his  head.      The  patiert  was  not  exposed,  aa 
the  day  was  warm,  and  no  water  was  employed  on  his  body. 
Hf  aurvived  only  twelve  hours,  the  abstraction  of  this  stimulus 
from  the  skin.      So  necessary  had  this  unnatural  stimulus  be- 
come to  support  life,  in  his  enfeebled  condition,  that  he  sunk 
and  died  almost  liumediutely  upon  its  removal. 


0 


M 


I   1 


1         I 


i   ;    ■ 


1 

1 

nir 

4* ■'  ■ 

80 


MEDICAL  SKETCHES. 


ABUSE  OF  CALC3IEL. 


I'ili 


Submuriate  of  mercury,  (calomel)  was  in  general  use  amuug,' 
the  army  and  ho8i)ital  surgt'ons.  The  well-known  fact  that  fe<~ 
ver,  under  some  of  its  forms,  will  yield  to  its  operation  when 
administered  in  full  doses  for  a  cathartic,  and  that  beneficial  ef- 
fects have  been  noticed,  when  given  in  small  doses  as  an  altera- 
tive; led  to  its  incautious  employment  in  field  practice.  When 
calomel  was  atlministfered  in  camp  with  no  more  precaution  than 
a  very  inactive  medicine  might  have  been ;  if  it  did  not  produce 
immediately  its  salutary  effect,  it  induced  a  dangerous  state  of 
debility  on  the  stomach  and  bowels.  Hence  it  was,  that  calo- 
mel proved  frequently  injurious  in  disorders  of  the  bowels,  as  al- 
so typhous  fever  on  the  Niagara,  during  the  summer  and  autumn 
of  1813,  while  the  men  were  exposed  in  tents  to  the  diurnal 
transitions  of  weather.  ' 

Some  of  the  surgeons  of  the  army  did  not  reflect,  that  calomel 
should  not  be  admii  isiered  to  their  patients  when  exposed  to 
cold  and  moisture,  even  if  in  a  dry  habitation  it  might  have 
been  the  most  suitable  medicine  in  similar  states  of  disease.  Up- 
on a  body  exposed  to  the  weather,  calomel  loses  its  salutary  pow- 
ers, and  exhibits  its  deleterious  effects. 

It  was  most  evident,  calomel,  under  the  above  circumstauceti, 
co-operated  with  the  existent  causes,  to  render  the  disorders  of 
Ihe  bowels,  and  diseases  combined  with  them,  more  formidable. 

Calomel  should  never  be  administered,  unless  the  patient  is  so 
situated,  that  the  skin  may  be  preserved  in  its  natural  warmth. 
If  this  was  not  attended  to  during  its  administration,  either  the 
bowels  or  the  glands  of  the  mouth  suffered.  To  one  of  these 
parts  it  frequently  directed  its  whole  st''"  mating  powers,  and  in- 
duced on  one  or  the  other  high  degrees  of  inflammation,  which 
terminated  in  mortification  of  the  intestines,  or  destruction  of 
iiot  only  the  muscles,  but  the  bones  of  the  face.       » 

Four  cases,  under  these  formidable  effects  of  mercurial  pty ; 
alism,  were  admitted  into  the  general  hospital  at  Lcwistown ; 


¥ 


CAMPAIGN  OP  1813. 


81 


three  of  whom  died  with  their  jaws  anil  faces  dreadfully  muti- 
lated. I^he  fourth  recovered  with  the  loss  of  the  inferior  max- 
illa on  one  side,  and  the  teeth  on  the  other.  He  lived  a  most 
wretched  life,  deformed  in  his  features,  (when  I  last  saw  the  pa- 
tient) incapable  of  taking  food,  except  through  a  small  aperture 
in  pifice  of  his  mouth.  The  above  interesting  case  is  described 
at  lurce,  by  Doctor  WriiTBiDOE,  one  of  my  assistants  in  the  hos- 
pital at  Lewistown,  in  the  following  manner  : 

Grccnhush,  25th  May,  1814. 

"  Sir, — Mercury  has  very  .justly  been  styled  the  "  Sampson 
of  the  Materia  Medica."  It  has  also  (by  a  physician  of  ray  ac- 
quaintance) been  emphatically  called  his  "  sheet  anchor."  It  is 
a  medicine  of  such  gigantic  strength,  which  may,  according  to 
the  application  of  it,  either  build  up  or  pull  down  the  "  pillars  ot 
the  constitution." 

"  In  the  hands  of  the  judicious  physician,  it  is  an  article  of  ia- 
estimable  value,  and  one  of  the  greatest  blessings  to  the  human 
race,  not  only  as  a  prophalactic,  but  an  agent  by  which  he  erad- 
icates disease,  and  restores  health.  On  the  contrary,  in  the 
hands  of  the  ignorant  or  the  empyric,  it  may,  and  sometimes  does 
prove  an  agent  by  which  he  not  only  augments  the  maladies  of 
human  flesh,  but  produces  new  diseases,  subverts  the  laws  of  na- 
ture, breaks  down  the  human  constitution,  and  often  proves  the 
source  of  incalculable  mischief. 

"  An  able  writer,  in  speaking  of  mercury,  observes,  that  it  is  an 
'article  of  materia  medica,  possessing  such  activity  in  some  con- 
ditions of  the  living  system,  as  may  be  capable  of  producing  great 
and  salutary  changes.  But  in  effecting  these,  certain  premises 
and  indications  are  to  be  attended  to,  to  justify  the  exhibition ; 
and  the  physician,  who  does  not  give  himself  the  trouble  to  con- 
sider these  circumstances,  may  perform  the  part  of  an  execu- 
tioner.' 

"  I  have  seen  no  less  than  four  cases,  where  death  was  pro- 
duced outright  by  the  improper  administration  of  mercury ;  be- 
sides innumerable  instances,  in  which  the  constitution  was  eith- 
er partially  or  wholly  destroyed  ;  coughs,  rheumatisms  and  other 


Ml 


I*  ,! 


V.l  i< 


11 

i  "  . 

)'A 

r 


jf 


«£ 


MEDICAL  SKETCHES. 


r 

8 


!'1 


liP' 


disorders,  ninny  of  whiclmverc  incurable,  produced  by  tbe  iur* 
proper  exhibition  of  this  moBt  potent  article,  ''i  '' ' 

"  You  must,  sir,  as  well  as  myself,  in  the  course  of  your  or  my 
practice,  have  seen  much  injury  done  in  this  way,  by  the  indis- 
criminate, and  improper  administration  of  mercury,  in  its  vari- 
ous forms  to  soldiers,  in  northern  latitudes;  placed  in  l)ad  quar- 
ters, or  in  camp,  or  on  mtirshes,  ex|)08ed  to  a  cold  and  damp  at- 
mosphere, to  night  air,  storms  and  va|)onr,  whose  l)ed  is  tbe 
earth,  and,  perhaps,  whose  only  covering  is  the  canopy  of 
heaven ! 

"  After  what  has  been  said  by  Wilson,  Trotter,  Warren,  and 
others  on  thie  use  and  abuse  of  mercury,  is  it  not  surprising,  that 
Ave  should,  every  day,  have  so  many  instances  presented  to  us» 
of  the  t^^ngrant  abuse  of  this  important  remedy  ? 

"  I  have  selected  the  following  case,  (though  not  a  fatal  one) 
chiedy  because  it  affords  a  striking  illustration  of  the  baneful  ef- 
fects of  the  impro|>er  use  of  mercury,  and  also,  because  it  in- 
volves an  important  surgical  operation.  1  shall  describe  the 
case  in  as  brief  a  manner  as  possible.  :  -   < 

*'  Thomas  Broughton,  of  the  6th  regiment  of  U.  S.  infantry, 
a  sprightly  lad  of  about  seventeen  years  of  age,  fell  into  my 
hands  upon  the  Niagara  frontier,  (Lewistown  hospital,)  in  July 
last,  with  a  disease  at  that  time  wholly  mercurial.  I  could  not, 
with  certainty  or  precision,  ascertain  the  nature  of  the  dis&asc, 
which  occasioned  the  exhibition  of  the  mineral ;  but  believe  it 
was  a  febrile  c"  nplaint. 

*'  When  he  was  first  placed  under  my  .charge,  he  was  extreme- 
ly  weak  and  emaciated,  had  a  slight  cough,  attended  with  a  pro- 
fuse diarrhoea,  cheerful,  and  in  good  spirits,  feared  nothing — 
which,  by  the  by,  is  characteristic  of  most  soldiers,  but  was  re- 
markably Ibo  case  in  this  instance.  Mortification  had  taken 
place  iu  the  buccinator  muscle  of  his  right  cheek,  and  under  his 
jaw,  and  h;*fl  been  progressing  several  days.  The  hole  in  his 
cheek,  occasioned  by  tbe  sloughing,  (when  I  first  saw  him,)  was 
about  three  quarters  of  an  inch  in  diameter,  perfectly  round,  and 
had  the  appearance  of  being  cut  out  with  a  knife,  or  some  sharp 
instrument.  That  under  his  jaw,  about  Uie  size  of  a  goose 
(iuill. 


ilili 


\n 


CAMPAIflN  OF  1813.  89 

'« I  placed  him  under  the  charge  of  a  raithfiil  nurse,  whose  sole 
oare  was  to  attend  this  one  patient.  I  directed  his  mouth 
(which  was  very  offensive)  to  be  kept  perfectly  clean,  by  in- 
jecting into  his  mouth,  and  through  each  of  these  orifices,  warm 
water,  diluted  brandy,  «S:c.  by  means  of  a  small  syringe.  I  or- 
dered at  first  gr.  xxv,  and  afterwanls  gt.  c.  l.  Fowl.  min.  solut. 
to  be  mixed  with  a  little  water,  and  his  mouth  syringed  with  it: 
I  directed  a  repetition  of  this  quantity  five  or  six  timfs  a  day, 
taking  care  that  it  was  not  swallowed.  In  the  interim  to  be 
washed  every  half  hour  with  tine.  cine,  oflic. 

"  Bark  (cine,  oft'.)  and  wine  or  brandy  was  given  him  inter- 
nally,  in  large  quantities  : — the  tine.  opii.  was  also  administered 
lar<fely,  not  only  to  check  the  diHrrhma,  but  as  a  general  stimu- 
lant (upon  the  princi|)lc8  of  Pott,*)  to  arrest  the  progress  of  the 
niorlification.  Under  this  treatment,  sphcelation  continued  to 
pro!;res3,  until  the  orifice  in  the  cheek  had  attained  to  about  the 
iize  of  half  a  crown,  aod  that  under  his  tongue  to  the  size  of  half 
a  pistarene. 

"  In  a  few  days,  however,  his  system  became  braced,  his  diar- 
rhoea abated,  his  appetite  improved,  and  his  general  health  a- 
mended  ;  so  that  the  progress  of  the  mortification  was  arrested. 

"  Shortly  after,  granulations  were  thrown  out  from  the  edges 
of  each  of  the  orifices,  and  their  sides  gradually  a[);)roximated. 
Notwithstanding  the  caries  of  the  bone  cuntiiuied  to  progress 
slowly,  the  teeth  were  loose,  and  as  they  became  troublesome 
were  taken  out,  one  after  another,  until  all  the  teeth  upon  the 
right  side  of  the  jaw  were  removed,  the  incisivi  fir^t,  and  after- 
wards the  molares. 

"  Much  advantage  seemed  to  be  derived  from  the  local  appli- 
cations, as  well  as  the  general  remedies,  particularly  the  arseni* 
as  jMjtassjc. 

"  This  system  was  rigidly  pursued  several  months,  great  at- 
tention paid  to  him,  and  particular  care  taken  to  keep  his  mouth 
clean,  and  to  prevent  as  much  as  possible  the  foetor  arising  from 
the  carious  jaw.  The  diseased  bone  at  length  became  loose, 
^iid  gradually  separated  at  the  symphysis.     With  a  pair  of  for 

*  Vide  Pott's  Worksi 


1 

1 

■'l 

/ 

1 
t 

;  * 

:       1 
i    . 

,  'i 

I 


u 


MEDICAL  SKETCHES. 


I  I 


Hill 


I  :| 


ceps,  I  frequently  raisei  it  a  little  from  its  nndiral  situation,  and 
by  imiiresfling  lateral  motion  u|)on  it,  could  move  it  a  little  from 
side  to  side,  but  was  at  that  time  unable  to  extract  it.  The  al- 
veolar processes  of  the  incisores  and  cuspiditi  irritated  and  cut 
his  tongue  considerably,  in  consequence  of  which  I  removed 
them.     The  two  orifices  though  much  contracted  did  nul  close. 

"  He  remained  in  this  situation  until  after  the  n.'i[)ture  of  tort 
Niagara,  and  burning  of  the  villages  upon  that  frontier  by  the 
British  array;  when  1  took  him  (in  January,  1811)  together 
with  all  the  sick  and  wounded  upon  that  station,  and  ttrought 
them  to  Greenbush;  after  which  I  did  not  see  Broughtoii  for 
several  weeks;  during  which  time  the  diseased  tmne  had  lie* 
come  more  firm,  and  shewed  very  little  disposition  to  se|)arate. 
Indeed,  I  considered  the  removal  of  the  bone  altogether  impruc« 
ticable  by  any  other  means  than  that  of  an  operation. 

"  Two  unsuccessful  attempts  were  m;ide  by  a  surgeon  (chief 
of  the  medical  staff  at  this  post)  to  pull  it  out  of  his  mouth  with 
a  pair  of  forceps,  when  at  the  same  time  his  mouth  could  not  be 
opened  to  exceed  half  an  inch.  And  at  anotiier  time  to  saw  off 
the  end  of  it.  He  afBrmed,  that  the  operation  i  proposed  could 
not  be  performed ;  and  if  it  were,  the  wound  occasioned  i)y  it 
eould  not  be  healed. 

"  As  the  diseaseil  portion  of  the  bone  nauseated  the  patient, 
and  was  very  oflensive  to  those  around  him,  not  finding  any  ad- 
vantage from  further  delay,  1  stated  to  him  what  would  be  nec- 
essary in  order  to  complete  the  cure,  and  proposed  to  lay  open 
his  cheek,  and  extract  it  surgically ;  to  which  the  patient  readi- 
ly assented. 

"  Accordingly  the  necessary  preparations  were  made,  and  the 
patient  placed  in  an  horizontal  position,  upon  a  table  of  conven- 
ient height,  and  the  operation  performed.  With  a  probe  point- 
ed bistoury,  1  commenced  my  incision  at  the  angle  of  the  mouth, 
divided  the  orbicularis  oris,  and  the  muscles  of  the  cheek  to  the 
orifice  in  the  buccinator,  and  continued  the  incision  through 
this,  into  the  substance  of  the  masseter  muscle.  The  facial  ar- 
tery, by  this  incision,  was  divided.  The  hemorrhagy  Avas  such 
as  to  render  ligatures  necessary  before  I  could  proceed  with  thr- 


CAMP  Aid  N  OP  11113. 


85 


opcrallon.  I  made  u  li&;<tturc  upon  r!U!li  o(  i\\o  moiillifl  of  tlic  di- 
vidcd  artrry,  and  then  urorcnU'd  \o  Kt'pandr  tlu*  lioiir  from  its 
lutcrnl  connections,  and  lo  dissrct  it  u|i  from  tlir  8ul>inc(>nt  mus* 
cics,  to  wiiidi  it  was  Htill  firndy  attaclicd  ;  after  which,  with  a 
•i\%rv^  motion,  loijetiier  with  a  little  extension  upon  the  Iione,  I 
was  enabled  to  separate  it  from  the  sound  portioti  (»f  the  maxilla 
inferior  about  half  way  between  the  angle  of  the  jaw,  and  the 
condyloid  process. 

"  The  parts  were  then  brou^lit  tojjethcr,  their  cdpcs  kept  in 
conl.ict  by  means  of  the  interrupted  suture,  at  the  nnple  of  the 
month,  and  Uy  strips  of  adhesive  plaster  through  the  remainder 
of  the  incision.  Perhaps  the  twisted  suture  would  have  been 
better,  but  this  I  was  unal>lc  to  employ  for  want  of  hare-lip  pins. 
TJie  dressings  were  then  applied,  and  the  jiatient  taken  to  bis 
quarters,  placed  in  bed  upon  his  left  side,  and  kept  in  that  situa* 
tion  to  prevent  the  saliva  from  insinuating  itself  between  the 
lips  of  the  wound.  The  wound  healed  by  the  first  irdention 
through  the  principal  part  of  its  course.  The  fistulous  openings 
both  soon  closed,  and  the  pulient  gradually  recovered  without 
much  disfiguration.  The  chism  has  been  filled  up  by  ossifift 
matter,  thrown  out  l)y  the  secerning  arteries;  ossification  seems 
already  to  have  commenced,  .and  it  is  probable  a  new  bone  will 
eventually  supply  the  place  of  the  old  one  by  the  process  of  os- 
teogeny. He  now  eats  and  converses  very  well,  which  before 
were  performed  with  difficulty.  His  general  health  is  good,  and 
the  contour  of  his  face  is  daily  improving,  so  that  there  is  a  pros- 
pect of  his  yet  becoming  (juite  a  handsome  man." 

(Signed)  J.  B.  WHITRIDGE, 

Assistant  Hospital  Snr^con, 

To  James  Manv,  Hospital  Stirgeon, 
17.  S.  Army,  at  Burlinglun,  Vermont, 

I  have  so  frequently  witnessed  the  injurious  effects  of  merca- 
rials,  particularly  calomel,  when  a«lministered  to  soldiers  in  the 
field,  it  is  my  decided  opinion,  it  never  should  be  employed  to 
men  under  such  circumstances,  except  in  combination  with  some 
-■'otive  cathartic.  To  soldiers  under  typhous  fever,  or  of  an  in- 
12 


80 


MEDICAL  SKETCHES. 


niimmalory  fypc,  it  wna  equally  injiirioufl  when  claily  reprafrd. 
liif«t«a(l  of  rcrru'dyinc;  those  diseaaes  of  »ho  howela,  wliirh  pre- 
vailed  in  tnir  armies  on  Ihe  frontiers,  wljen  exhihiteil  to  mt  ii  ex- 
posed to  all  the  casualties  of  n  cam(>,  those  com;tlaiut8  deteri- 
orated l»y  its  fre<|ueiit  repetition.  Sy|ihililic  discasea  were  hut 
seldom  permanently  cured  hy  it,  during  campaigns.  Tliis  was 
in;ide  most  evident  to  the  surgeons  of  hospitals,  hy  the  nunihers 
admitted  with  these  complaints,  wliich  had  heen  of  some  months 
duration,  after  the  army  retired  into  winter  quarters. 


ill 


I  ^'i 


The  foUomn:^  SypliilHic  cases  rvcrc  recorded  In/  Doctor  IMarch 
of  the  Hospital  department^  and  are  here  inserted  to  slicw  the 
injurious  effects  of  mercurial  practice  in  lenls. 

CASK    FIRST. 

"  RicliarA  ^lahhar,  private  of  the  10th  regiment,  Avns  ad/nit- 
ted  into  general  hospital,  at  Greenhush,  Octol)er  13,  IB  12,  with 
the  venereal  disease.  lie  had  administered  him  hy  a  regiment- 
al surgeon,  five  or  six  doses  of  calomel ;  also  had  used  an  injec- 
tion of  a  solution  of  the  acetite  of  lead.  October  15th — Ilia 
mouth  hat'  hecome  very  sore,  having  also  a  profuse  ptyalism ;  a 
♦lose  of  suits  was  prescribed.  17th — The  mouth  extremely  sore; 
gums  and  face  much  swollen;  the  saliva  profuse  and  mixed  with 
blood;  ellluvia  consocpient  ujwn  salivation,  very  disagreeable. 
A  solution  of  alum  was  used  as  a  gargle.  18th — Mouth  still 
extremely  sore;  blood  and  saliva  flowing  continually,  'i'he 
discharge  was  not  less  than  a  pint,  or  a  pint  and  half  in  twenty- 
four  hours.  Bark  and  wine  were  directed.  19th — Mouth  and 
face  as  yesterday.  Bark  and  wine  continued.  A  decoction 
of  white  oak  bark  in  which  alum  was  dissolved,  was  prescril)- 
ed  for  a  wash  and  gargle  for  the  mouth.  201h — Bleeding  had 
somewhat  abated.  Medicines  as  yesterday.  21st — Symptom? 
coutiiuied  the  same,  and  the  same  medicines  repeated,  with 
tlie  addiiion  of  a  dose  of  sulphate  of  soda  for  a  cathartic.  From 
llie  22(1  to  the  24lh,  the  last  medicines  were  continued,  except 
ing  the  cathartic ;  two  teeth  fell  out  of  his  jaw,  followed  by  a 
discharge  of  pus  mixed,  with  blood  and  saliva.  271h — Sulphate 
of  soda  for  a  catliartic.     2olh — Hemorrhage  considerably  abat 


CAMPAION  OP  \H\A. 


n 


uA;  hMk  nml  wine  continue*!.  HOlli — IMiicIi  hotter;  bark  n ml 
wine  na  lu'tun\  Olst — Cntliarlio  of  8iil|»hate  of  uixla.  Novon*- 
brr  let — Convah'scctl  fait.  The  o.ntl«artic»  8«cnuHl  of  great 
benefit;  the  succeedinc;  days  took  hnrit  ami  wine.  4tli — Took 
a  (lose  of  eulpliate  of  aoda.  From  tltis  time  recovery  was  rapiiV, 
ami  the  ptyalism  had  almost  ceased;  and  by  the  t7lb  of  N07 
vember  he  was  entirely  recovered  from  the  venereal  affectiori, 
and  also  from  the  distressing  eiTecta  of  mercury.  This  ca<!e  il- 
lustrates the  beneficial  effects  of  cathartics  in  checking  the  ex- 
citement on  the  salivary  ji^lands;  also,  the  alarming  elTecIs  ol' 
mercury  under  exposed  circumstances.  This  patient  scarcely 
escaped  death.  For  several  djiys  appeared  in  a  moribund 
state." 

CASE    SECONT). 

"  James  Cady,  private,  regiment  light  artillery,  admitted  into 
the  general  hospital  at  Greeid)ush,  October  4,  1812,  with  lues 
venerealis.  The  prepuce  and  glans  penis  were  much  swollea 
and  indamcd,  with  several  chancres.  This  patient  had  lieea 
treated,  while  in  his  tent,  by  calomel ;  in  consequence  of  expo- 
sures and  irregularities,  the  complaint  increased.  He  was  put 
on  calomel,  gr.  2.  night  and  morning,  sometimes  it  was  combin- 
ed with  opium  to  prevent  its  operation  on  the  intestines,  and  to 
allay  the  pain  of  the  local  irritation.  A  solution  of  acelite  of 
lead  was  applied  to  the  indiimed  parts.  October  3tb  and  Uth, 
the  calomel  was  continued  and  the  cluincres  dressed  with  cerate 
armed  prccip.  rub. — swelling  had  little  subsided.  7th — Calomel 
continued;  the  gums  began  to  be  slightly  affected;  swelling 
continued  to  suliside.  81h — Ptyalism  had  commenced;  calomel 
omitted;  chancres  assumed  more  favorable  appearance;  contin- 
ued the  mercurial  dressings.  9lb  to  12th — Swelling  of  pre|nice 
increased  in  consequence  of  irregularities,  and  exposures  to 
cold;  mercurial  frictions  on  the  thighs;  pill  of  opium  at  night. 
20tli — The  prepuce  in  a  suppurating  state ;  an  emollient  poul- 
tice ;  ptyalism  continued ;  the  above  method  was  pursued,  vary- 
ing the  treatment  according  to  s;  .nptoms,  several  weeks,  when 
the  patient  was  discharged  cured.  In  this  case  it  was  most  evi- 
dent that  cold  had  a  strong  tendency  to  increaac  every  alarm- 


II 


If 


i',i!i 


IMAGE  EVALUATION 
TEST  TARGET  (MT-3) 


/. 


^ 


ri^. 


^^  5^^X- 


z/. 


1.0 


1.1 


1.25 


|50     *^~        lii^Hi 

I   US.    12.0 


12.2 


^  IIIIMi 


6" 


V] 


^  ^ 


^ 


^ 


'/ 


Photographic 

Sciences 
Corporation 


\ 


^ 


,v 


<> 


[V 


6^ 


23  WeST  MAIN  STRf  ET 

WEBSTER,  N.Y.  14580 

(716)  872-4503 


% 


^ 


s 


Sb 


MEDICAL  SKETCHES. 


m§ 


ing  syniplotn  or  disease,  at  the  same  time  the  niercuiial  acliou 
on  the  glands  of  the  mouth  was  aggravated." 

In  Himilar  cases  oi'  ihis  disease,  the  nitro-muriate  of  gokl  has 
since  been  employed  with  the  best  effect,  without  the  unpleas- 
ant salivation  produced  by  mercurials. 

A  discriminating  line  between  those  cases  where  calomel  is 
admissible,  and  those  where  it  may  prove  injurious,  even  under 
the  most  favourable  circumstances,  is  not  always  correctly 
drawn.  Calomel,  in  full  doses  for  a  cathartic,  is  a  powerful  and 
safe  remedy  in  sthenic  diathesis.  But  its  administration  in 
small  doses,  with  a  view  of  removing  the  primary  strong  diseas- 
ed action  of  this  diathesis,  by  inducing  a  new  mercurial  action, 
previous  to  its  reduction  by  depleting  the  blood  vessels,  and 
evacuating  the  contents  of  the  intestines,  will  frequently  defeat 
the  intention. 

I  have  witnessed  a  febrile  disease  of  the  sthenic  diathesis  to 
increase  during  the  continued  exhibition  of  calomel  in  small  do- 
ses, until  the  mouth  was  very  much  inOamed;  so  that  it  was  not 
easy  to  determine  whether  the  existent  state  of  the  disease  Avaa 
the  effect  of  its  original  cause,  or  the  consequence  of  mercurial 
excitement. 

It  has  been  also  observed,  in  asthenic  fevers  attended  with 
great  debility,  with  torpor  of  the  stomach  and  bowels,  and  pro- 
fuse diarrhwa — that  calomel  increased  the  dangerous  state. 


!  i 


ABUSE  OF  TARTRITE  OF  ANTIMONY. 


I     : 


it  'i 


PaiNfii.E,  in  his  "  diseases  of  the  army,"  noticed  the  injuri- 
ous effects  of  antimonials,  or  their  inetficiency  to  cure  the  disea- 
ses incident  to  soldiers,  when  exposed  in  camp.  It  is  with  re- 
gret that  I  feel  myself  bound  to  record  the  bad  consequences  of 
the  administration  also  of  tartrite  of  antimony,  in  one  of  the  hos- 
pital wards  .at  Lewistown.  A  young  surgeon,  upon  taking 
charge  of  this  ward  of  about  60,  observed  to  me  that  these  bow- 
el complaints  ^YOuld  readily  yield  to  emetic  tartar,  in  small  do- 


CAMPAIGN  OP  1813. 


89 


ses.  He  was  cautioned  not  to  employ  this  medicine.  It  vim 
observed,  tliese  diseases  were  not  recent  affections ;  and  havfng 
lieen  of  dome  duration^  evacuants  had  been  carried  to  their  full 
extent,  previous  to  their  admittance  into  the  hospital ;  and  Tur- 
tliermorc,  antimonials  were,  but  in  few  instances,  admissible  in 
field  practice,  while  men  were  exposed  to  the  transitions  of  wea- 
ther in  tents.  These  precautions  were  disregarded.  The  fol- 
lowing weekly  report,  out  of  500  patients,  gave  10  deaths;  9  of 
whom  were  out  of  the  above  ward  of  GO. — The  succeeding  week 
8  deaths  were  reported ;  6  of  whom  out  of  the  same  ward.  At 
this  time  1  was  confined  to  my  tent,  and  unable  directly  to 
correct  the  abuse  by  prescribing  to  the  sick.  The  other  two 
gentlemen.  Surgeons  Whitridge  and  Vanhovenburgh,  had  more 
in  their  wards  than  they  were  able  to  attend  and  do  them  strict 
justice. 

Having  been  informed  that  I  was  dissatisfied  with  so  dispro- 
portionate ill  success,  as  was  exemplified  by  reports ;  this  young 
surgeon  wished  to  be  informed  the  practice  pursued  by  myself. 
Too  feeble  to  enter  into  a  minute  detail  of  practice  most  suitable 
in  these  diseases  of  the  bowels,  he  was  referred  to  Doctors  Whit- 
ridge and  Vanhovenburgh,  whose  practice  had  been  accompan- 
ied with  more  success. 

From  the  Ist  of  July  to  the  30th  of  December,  the  number  of 
sick  admitted  into  the  general  hospital  at  Lewistown,  were  be- 
tween 950  and  1000.  During  this  period,  59  deaths  were  re- 
ported— nearly  half  of  whom  died  in  a  small  ward  of  60  patients 
in  the  course  of  about  three  weeks ;  most  of  these  by  an  impru- 
dent and  injudicious  administration  of  tartrte  of  antimony. 

It  has  been  observed  that  intermittents  were  among  the  forms 
of  disease  on  the  Niagara,  during  this  camiiaign.  A  compan}^ 
of  volunteers  stationed  at  Schlosser,  one  mile  from  the  great  cat- 
aract, during  the  summer  months,  were  nearly  all  attacked  with 
intermittent  fevers  of  the  tertian  type.  There  are,  in  this  vicin- 
ity, extensive  swamps  and  stagnant  waters.  Twenty-five  pri- 
vates of  this  company  were  admitted  at  one  time  into  the  gener- 
al hospital,  sick  with  this  disease ;  who,  previous  to  their  admit- 
tance, had  been  deatitu;.;2  of  medical  aid.    A  few  cases  among 


'I 


iMi  !! 


'.<ljy(>fgy(^«gpP9q^Vn"Pn^f">q"KV«qr- 


4» 


MEDICAL  SKETCHES. 


/  '■ 


illit 


I  ill-;'  ^ 


ti!:. 


the  number  were  found,  which,  during  the  hot  stage  of  the  fevcr^ 
exhibited  great  Increase  of  iieat  and  arterial  excitement.  These 
were  bled,  apparently,  with  benefit.  Emetics  and  cathartics 
tvere  prescribed  for  tJie  whole;  the  first,  with  intention  ofcouii- 
teracting  the  cold  stage  of  the  fever,  were  administered  at  its  ac- 
cession ;  the  last,  with  a  view  of  removing  irritation  from  the 
intestines,  and  reducing  sthenic  diathesis ;  and  both,  having  for 
our  object  a  more  equalised  excitement.  After  these  evacua- 
tions had  been  carried  to  an  extent  which  was  judged  sufficient, 
bark,  snakeroot,  aromatics,  and  wine  were  directed,  in  moderalo 
and  larger  quantities  during  the  intermission  of  fever;  not,  how- 
ever, with  all  the  benefit  which  was  expected.  The  last  medi- 
cines, in  a  few  instances,  arrested  the  paroxisms  a  short  period 
only;  while,  in  general,  they  had  no  elfeci.  Not  one  experien- 
ced a  permanent  cure  by  the  above  means. 

After  being  thus  disappointed  with  remedies  in  most  common 
use,  recourse  Avas  had  to  Fowler's  mineral  solution,  a  remedy 
held  in  high  estimation  for  the  cure  of  intermittent  fevers.  Thifl 
experiment  made  by  us  at  this  time  confirmed  the  great  reputa- 
tion which  this  arsenical  preparation  had  acquired,  in  the  hand^ 
of  other  physieans.  This  potent  medicine  acted  almost  like  a 
charm.  It  did  not  fail  in  one  instance,  to  remove  the  paroxisms 
of  fever  Avithin  five  or  six  days,  some  of  whom  had  taken  tlie 
bark  a  fortnight,  or  more,  without  permanent  eflect.  Ina  few- 
cases  two  or  tliree  doses  of  from  five  to  ten  drops  of  the  mineral 
solution  effectually  removed  tlie  paroxisms.  The  convalescents 
from  this  fever  were  benefitted  by  the  bark  and  wine,  inasmuch 
as  the  stomach  and  digestive  powers  were  imjjroved  by  their 
use. 

After  the  retrograde  march  of  the  army  from  Stony  Creek,  no 
expedition  against  the  enemy  was  undertaken,  except  the  disas- 
trous movement  of  a  detachment  to  the  Beaver  dams  ;  at  which 
place,  600  men  under  the  command  of  Colonel  Borstler,  after  a 
feeble  resistance,  surrendered  to  an  inferior  force. 

While  waiting  the  arrival  of  the  Heet  from  Sackett's  harbour, 
under  the  command  of  Commodore  Chauncy,  to  co-operate  with 
4he  army ;  and  the  drying  of  the  roads,  which  had  been  irapasao. 


CAMPAIGN  OP  1813. 


n 


fele  for  waggons,  most  necessary  for  the  transportation  of  provi- 
aioiis,  in  a  contemp'iHted  expedition  against  the  enemy  at  Bur- 
lin'i;ton  heights,  in  the  event  of  any  failure  of  assistance  from  the 
fleet;  General  Dearborn  was  employed  the  month  of  June  and 
part  of  July,  in  making  prei)aration3  for  the  expedition,  by  or- 
giinizing  and  disciplining  the  troops,  a  considerable  part  of  whom 
had  been  recruited  the  preceding  winter.  In  the  mean  time  the 
encampment  was  secured  against  surprise.  Fort  George  was  re- 
duced in  its  dimensions,  and  its  lines  of  defence  strengthened  l)y 
a  deep  ditch  and  palisades.  These  preparations  were  in  for- 
wardness to  recommence  operations  against  the  enemy,  wliich 
were  momently  and  anxiously  anticipated  by  the  officers  of  the 
army,  when  General  Dearborn  was  removed  from  this  com- 
mantl.* 
From  this  period,  14th  July,  until  the  first  week  in  September, 
when  General  Wilkinson  assumed  the  command,  the  army  at 
Fort  George  consumed  ihe  most  eligible  season  of  this  summer 
and  ai:lumn,  for  effective  service;  cooped  within  the  narrow  lim- 
its of  a  Tew  acres  of  land,  by  a  force  of  the  enemy  not  exceeding 
one  half  its  strength.  And  under  constant  ap|)rehension  of  an 
attack,  placed  itself  wholly  in  a  state  of  defence.  This  appar- 
ent pusillanimity,  or  want  of  energy  on  the  part  of  the  army, 
emboldened  the  enemy  to  insult  it,  by  repeated  attacks  upon  its 
advanced  piquets,  night  after  night,  during  the  above  period; 
and  on  the  24th  of  August,  a  general  attack  was  made  on  the 
lines  by  Sir  George  Prevost,  and  was  repulsed  with  loss. 
This  petit  guerre  kept  the  army  in  constant  alarm,  and  sub- 

*  The  removal  of  Major  General  Dearborn  from  this  coramanti,  was 
exceedingly  regretted  by  the  officers  of  the  army.  Whatever  miglit  have 
been  the  object  of  this  procedure,  subsequent  events  have  demon,stratcd  that 
its  policy  was  very  injudicious  General  Dearborn,  at  the  time  of  his  re- 
moval, had  recovered  his  health  ;  and  preparations  were  in  forwardness  to 
recommence  activfe  operations  against  the  enemy ;  which  had  been  delayed 
iu  consequence  of  tiie  badness  of  the  roads,  almost  impassable  for  waggons, 
until  the  month  of  July,  waiting  the  arrival  of  the  fleet  to  cooperate  with 
Irim.  The  fulle!;t  evidence  which  can  be  given,  that  the  General  possessed 
llie  entire  t-orfidence  of  the  army,  is  the  affectionate  address  to  him,  signed 
by  General  Boyd  and  every  field  officer  present,  when  he  took  his  leaved 


IP 


1    ■'• 


i-1 


\m 


;  t 


it.    I 


i 


02 


MEDICAL  SKETCHES. 


Ml 


■  'i  '  '■  i 


111' 
W','.. 


jectcd  the  troops  to  vexatious  fatigues,  unremitted  duty,  and  mul- 
ti|died  exposures,  which  prevented  them  frum  taking  tlieir  nec- 
essary repose. 

Under  the  above  mortifying  circumstances,  the  army,  in  con- 
sequence of  its  stationary  position,  suffered  from  diseases,  aggra- 
vated by  filth  accumulated  in  its  vicinity. 

From  this  last  period,  arrangements  were  ordered  for  some  im- 
portant  movement.  These  were  actively  and  unremittedly  ex- 
ecuted. Boats,  in  particular,  were  wantiiig  for  (he  transporta- 
tion of  at  least  four  thousand  men.  Those  attiiched  to  the  ar- 
my were  repairing,  wliile  others  from  various  parts  were  collect- 
ing. 

The  object  of  the  expedition  was  kept  a  profound  secret.  It 
called  forth  variant  opinions,  and  excited  lively  anticipations, 
that  the  reputation  and  honor,  which  had  been  lost  by  inglorious 
inactivity,  would  be  retrieved  by  some  bold  and  decisive  stroke 
upon  the  enemy.  These  animating  sensations  were  highly  ex- 
alted by  the  annunciation  of  the  capture  of  the  enemy's  llotilla 
on  lake  Erie,  by  Commodore  Perry ;  and  the  surrender  of  the 
British  forces  in  the  vicinity  of  Maiden,  to  General  Harrison. 
These  sanguine  expectations  were  almost  realised  when  those 
glorious  events  were  succeeded  by  reports  that  General  Harri- 
son had  already  embarked  on  board  transports  a  part  of  his  divi- 
sion, to  form  a  junction  with  that  of  General  Wilkinson.  With 
this  united  force,  it  was  expected  the  srmy  would  recommence 
otfensive  operations,  against  which  the  enemy  could  have  made 
but  a  feeble  resistance. 

These  high  wrought  anticipations  were  only  visionary  sug- 
gestions of  the  soldier,  ardent  in  the  cause  of  his  country,  and 
emulous  of  fame  and  glory.  These,  which  seemed  to  have  been 
ahead)/  within  the  grasp  of  the  army,  were  thrown  at  a  distance, 
by  the  orders  of  the  commander  in  chief,  to  embark  the  troops, 
including  the  convalescents,  and  move  down  lake  Ontario,  to 
Grenadier  Island ;  this  place  being  assigned  a  general  rendez- 
vous for  the  army. 

*'  Obedience  to  orders  is  tne  first  and  last  duty  of  a  soldier."' 
It  was,  nevertheless,    deeply  regretted  by  the  officers,  that 


"^T^^^^m 


CAMPAIGN  Of  1813. 


93 


j'*iW' 


t!i^  tittnj,  respectable  as  it  was,  should  retire  in  the  presence 
of  the  enemy,  much  inferiour  in  force.  And  after  having 
gained,  >vith  some  loss,  and  a  high  degree  of  .honor,  one  of 
his  most  important  [)Osts,  and  held  possession  of  it  five  months, 
should  abandon  the  conquest,  witiiout  accomplishing  the  prima- 
ry object  of  the  campaign ;  by  either  destroying,  or  capturing 
that  division  of  the  enemy  which  composed  his  right  wing,  in 
Upper  Canada. 

When  an  enemy  exhibits  great  military  tak  nts,  we  are  dispos- 
ed  to  allow  him  all  the  credit  due  him,  in  a  martial  point  of 
view,  even  when  by  lirtful  deceptions  and  judicious  manago- 
ment,  with  a  force  inferior,  he  was  enabled  to  apparently  check 
the  offensive  operations  of  our  army,  and  compel  it  to  place  it- 
self in  a  position  entirely  defensive. 

This  inactivity  while  the  army  was  under  the  command  of 
General  Bovn,  upon  whom  it  devolved  when  General  Dcae- 
BORN  retired,  excited  at  the  time  severe  public  animadversions. 
General  Bovo  had  in  possession  the  means  of  his  own  justifica- 
tion ;  he  owed  it  to  the  high  station  he  held  in  the  army,  as  well 
as  the  nation,  to  have  brought  to  public  view  at  an  earlier  peri- 
od those  documents  from  higher  authority,  which  governed  him 
in  the  measures  he  adopted,  while  he  commanded  at  Niagara. 
The  orders  Avhich  he  received  from  the  department  of  war,  it 
more  publicly  known,  Avould  exonerate  him  from  that  censure, 
with  which  he  is  now  loaded  in  the  opinion  of  the  public,  who, 
on  national  concerns,  are  too  much  disposed  to  pronounce  judg- 
ment, before  they  hear  the  cause.     (See  Note  F.) 

General  Wilkinson,  at  the  time  he  issued  his  orders  to  move 
down  Lake  Ontario,  directed  the  sick  and  convalescents,  too  fee- 
ble to  accompany  the  army,  should  be  sent  to  Lewistown,  under 
ray  charge,  with  an  order  to  "  furnish  them  with  winter  quarters 
out  of  the  reach  of  the  enemy,"  in  a  situation  which  I  might  es- 
teem most  eligible. 

The  last  weeks  of  October  were  most  uncomfortable  for  tlie  sick 
in  tents.  The  weather  liad  become  cold,  rainy  and  boister- 
ous. Winter,  with  its  dreary  attendants,  progressed  in  No- 
vember with  rapid  movement.    The  convalescents,  from  typhous 

and  diarrhoea,  in  consequence  of  the  sudden  trausiUom  of  ^>§ath- 
13 


n 


i      ■■!-      , 

I 
I 

11 

•'4 


MEDICAL  SKETCHES. 


1 
1 ' 


I. 


I 

I 

ii'l 


er,  had  renewed  attacks  of  disease  under  the  Torm  of  pneumonia; 
coughs  had  become  general  among  them.  These  changes  deter* 
mined  me,  after  spending  some  days  to  select  a  secure  position, 
and  prepare  quarters  for  the  approaching  winter,  to  break  up  the 
encampment  at  Lewistown.  We  had  at  this  time  about  three 
hundred  and  fifty  in  the  hospital,  including  the  sick,  convales* 
cents  and  invalids.  The  last  were  subjects  for  discharge,  in 
consequence  of  wounds  and  other  disabilities.  After  selecting 
one  hundred  who  had  so  far  recovered  from  wounds  and  bodily 
infirmities,  as  to  be  able  to  perform  a  Journey  of  three  hundred 
miles  to  Greenbush,  the  remainder  were  ordered  to  Eleven  Mile 
Creek,  called  Williamsville. 

These  arrangements  were  communicated  to  Colonel  (now 
General)  Scott,  who  had  been  left  in  command  at  Fort  George, 
and  met  with  his  full  api)robation.  To  the  assistant  quarter 
master  Ge  leral  of  the  post,  he  gave  his  order  to  furnish  the  neces' 
sary  means  of  transportation.  The  invalids  destined  for  Green-* 
bush  were  committed  to  the  charge  of  Lieutenant  Archer,  regi- 
mental pay  master,  and  Doctor  Hugo.  The  remainder  of  the 
sick  and  convalescents,  two  hundred  and  fifty  in  number,  some 
of  whom  very  debilitated,  were  transported  to  Schlosser,  a  dis- 
tance of  eight  miles,  in  waggons ;  thence  to  Black  Rock,  in 
boats ;  from  the  last  place  in  waggons  to  Williamsville.  This 
was  a  tedious  journey  of  forty  miles  for  sick  men,  many  of  whom 
were  destitute  of  cloathing,  suitable  for  the  approaching  inclem- 
ent season.  Previous  to  this  movement,  the  roads,  bad  at  best,  had 
been  rendered  almost  impassable  by  heavy  rains.  During  the 
journey  the  weather  was  cold  and  wet.  The  evening  on  which 
the  sick  arrived  at  Black  Rock,  a  storm  of  rain  commenced, 
with  a  violent  wind  from  the  west,  which  raised  the  waters  of  the 
strait  at  the  outlet  of  Lake  Erie,  eight  feet  in  two  hours ;  which 
swept  the  baggage  belonging  to  the  men,  and  a  quantity  of  hos- 
pital stores,  that  had  been  deposited  during  the  night  at  the 
landing,  down  the  river.  This  loss  was  severely  felt  by  many, 
who,  previous  to  this  unfortunate  casualty,  had  exceedingly  suf- 
fered for  want  of  clothing.  It  left  them  without  a  change  of  gar- 
{foents  of  any  description.     Tiie  hospital  department  by  this  sud- 


■  ■■WWJII 


II 


CAMPA.IGN  OP  1813. 


<a 


ien  flood  of  water,  besides  many  articles  very  necessary,  lost  be- 
tween 150  and  200  blankets,  a  more  serious  deprivation  than  evr 
ery  thing  besides,  under  existent  circumstances,  as  '.i  was  inipog' 
sible  to  replace  them. 

In  addition  to  the  above  disasters,  six  of  the  most  enfeebled 
died  during  the  removal,  Avho,  although  too  weak  to  encounter  th« 
cold  and  fatigues  attendant,  im|)orfunately  objected  to  being  lef^ 
at  Lewistown,  exposed,  as  they  must  have  been,  to  the  depred&r 
lions  of  the  savages  attached  to  the  British  army.  These  depr 
redations  were  strongly  apprehended,  afiei  the  army  retired  from 
tills  frontier.  That  these  apprehensions  were  not  without  foun* 
daf.on,  subsequent  events  have  ftjily  and  shamefully  demonstrat- 
ed.  Pour  weeks  previous  to  those  fatal  and  painful  disasters, 
which  succeeded  the  removal  of  the  army  from  the  Niagara,  they 
had  been  i)redicted.  At  that  time,  upon  learning  that  the  few 
troops  who  had  been  left  at  Fort  George,  mostly  militia,  were 
evacuating  the  post,  it  was  observed,  that  Fort  Niagara  would 
fall  into  the  hand?  of  the  enemy,  and  the  country  in  the  vicinitjr 
would  be  invaded  and  plundered. 

At  Williamsviile,  the  barracks  which  the  preceding  winter 
had  been  occupied  by  General  Smythe's  division,  were  put  into  a 
comfortable  state  of  repair,  and  improved  during  this  winter  as 
hospitals.  These  quarters  were  very  extensive,  and  were,  by 
much  labor,  rendered  commodious  for  the  number  who  composed 
this  detachment  of  sick  and  convalescents.  The  wards  were 
made  warm ;  this  was  more  important,  as  the  men  were  desti- 
tute of  clothing.  The  wards  were  not  crowded,  consequently 
were  less  liable  to  become  infectious.  Six  patients  only  were 
placed  in  a  room ;  wherefore  it  required  but  little  labor  and  at- 
tention to  preserve  them  in  a  state  of  cleanliness.  This  part  of 
duty  the  soldiers  were,  at  all  times,  obliged  punctually  to  ex- 
ecute. Those  regulations  which  had  respect  to  cleanliness  were 
always  scrupulously  enforced  within  tlie  hospitals  under  my  di- 
rection. -  ' 

The  sick  in  their  new  habitations  recovered  their  health  and 
strength  in  a  wonderful  planner.  Here  it  was  made  most  evi- 
dent, that  the  health  Qf  the  body  was  intimately  connected  with 


m 


ill 


$0 


MEDICAL  SKETCHES. 


:|i 


l!i 


■ill 


!|:i 


»l 


■■?.< 


m 


';!!' 


an  equable  and  iiiiiform  warmth  of  the  circumambient  almos* 
pbere.  Animal  life  cannot  be  suiiporteU  but  u  short  time  during 
the  seasons  of  severe  cold,  iuliss  the  temperature  of  the  body  i» 
preserved  in  an  equable  Hlale,  by  both  natural  and  artificial 
means.  The  first  arc  suitable  nutriment  taken  into  the  stomach, 
and  fresh  air :  the  last  are  geullc  exercise,  warm  clotbing,  and 
coirfortable  habitations.  Even  during  the  hot  season,  life  may 
be  destroyed  by  a  sudden  evaporation  of  heat  from  the  surface  of 
the  body.  In  the  hottest  day  of  our  summers,  a  healthy  man 
miiy  be  placed  in  a  situation  where  he  may  be  literally  chilled 
to  death  in  a  very  short  period  of  time. 

At  Williamsville,  before  three  weeks  had  expired,  fifty  of  the 
convalescents  were  reported  fit  for  duty,  and  were  or«lered  to 
Fort  Niagara.  The  barbarous  deaths  of  most  of  these  men,  with 
the  rest  of  that  ill-fated  garrison,  we  have  to  lament,  while  emo- 
tions of  just  indignation  irresistibly  obtrude  themselves,  when 
reflecting  upon  the  manner.  Surprised,  and  taken  without  resist- 
ance, most  of  the  garrison  were  deliberately  murdered  by  the 
bayonet,  after  surrender. 

Having  disposed  of  the  sick  in  quarters  for  the  winter,  in  con- 
formity to  the  orders  received  from  General  Wilkinson,  and 
finding  their  number  daily  decreiising ;  my  services  at  Williams- 
ville were  believed  to  be  no  longer  absolutely  necessary.  It  be- 
came my  duty,  as  it  was  my  inclination,  to  pursue  the  army  of 
General  Wilkinson  by  land  to  Sackett's  Harbor,  where  informa- 
tion might  be  obtained  to  what  point  from  Grenadier's  Island  it 
had  directed  its  course.  It  was  my  persuasion,  that  at  the  last 
place,  or  more  probably  at  Kingston,  in  Canada,  it  would  be  over- 
taken. Which  position  being  considered  the  key  of  the  upper 
province,  would,  in  possession  of  the  army,  have  been  of  high 
importance  to  its  future  operations.  With  these  impressions,  it 
was  my  ex,pectation,  that  this  important  post,  previous  to  the 
severe  frosts  of  winter,  would  fall  into  the  hands  of  our  army. 

Permission  was  received  from  General  Harrison,  who  had 
but  just  arrived  from  Detroit,  and  on  whom  the  command  of  the 
post  devolved,  to  leave  the  Niagara  frontier,  and  join  the  divi- 
•ion  of  General  Wilkinson.      The  charge  of  the  hospital  at 


It' 


{    i 


■II  iw  wjwm  1,1 


CAMPAIGN  OP  1813. 


n 


WiUiamsville  wa»  resigned  to  Doctor  WiuTniDOE,  who,  for  aa- 
liduoiis  attention  to  duly,  vutt  exceeded  by  no  physician  o(  tlic 
army.  The  services  of  tliis  gentleman  cannot  be  too  highly  a|)- 
predated.  To  him  not  only  the  nation  is  iiulehtcd,  but  my 
grateful  acknowledgments  are  due  ;  and  this  opportunity  is  im- 
proved, more  fully  to  express  them.  A  full  share  of  the  high 
reputation,  which  the  hospital  at  Lewistown  supported  during 
the  campaign  ;  as  announced  \n  the  fluttering  reports  of  the  1  nspec- 
tor  General  to  the  Commander  in  Chief  of  the  army,  ii  attribut- 
ed to  his  fidelity  and  good  judgment. 

k  «•«  «ty  «t«  ^ 


NIAGAIIA  FRONTIER. 


I"  CRT  Niagara  is  situated  on  the  east  side  of  the  strait  or  riv- 
er of  the  same  name,  at  its  outlet  into  Lake  Ontario.  It  is  a 
commanding  position  as  a  military  post.  This  fortress  was 
built  by  the  French  about  1725,  was  surrendered  1759  to  the 
arms  of  Great  Britain,  under  the  command  of  Sir  William  John- 
son, and  by  the  line  of  demarkation  settled  at  the  treaty  of  ()eace, 
1783,  fell  within  the  bounds  of  the  United  States  ;  but  was  not 
given  up  until  1 796.  The  river  or  strait,  35  miles  in  length 
forms  the  water  communication  between  lakes  Ontario  and  Erie, 
of  unequal  width,  from  half  to  six  miles  ;  in  the  upper  part  be- 
tween the  falls  and  Erie  are  several  islands,  the  largest  being 
13  miles  long,  and  six  broad,  equal  in  dimensions  to  a  large  town- 
ship. Seven  miles  above  the  mouth  of  the  river  is  the  head  of 
navigation,  where  the  village  of  Lewistown  is  laid  out  into  house- 
lots  ;  eight  miles  south  is  the  celebrated  cataract.  The  banks 
from  the  lake  to  Lewistown  are  as  perpendicular  as  they  can  be, 
composed  as  they  are  of  clay  and  loom,  from  fifty  to  seventy 
feet  above  the  surface  of  the  water,  and  are  different  from  all  I 
have  seen.  They  have  more  the  appearance  of  art  than  nature. 
From  Lewistown  to  the  falls  the  sides  of  the  banks  are  perpen- 


'    ! 


'II 


mar 


«0 


MBDICAL  SKETCHES. 


I    ! 


diciilar  1  fiO  feet  in  height,  supported  from  their  foundationB  to 
their  tops  liy  strata  of  oelcareous  rocl<»,  as  regularly  fixed  aB  if 
tl>ey  were  maHon  worlc.  Througli  the  whole  extent  of  the  river 
to  tlie  fnlls,  the  banlcs  do  not  slope,  as  is  usual ;  from  whose 
•ummit  there  is  no  passage  to  the  water's  edge,  except  where  ar- 
tificial  roads  have  been  constructed. 

The  distance  Trom  the  fi^lIs  to  Black  rock,  a  village  o{  ten  or 
fifteen  houses,  tlie  river  banks  are  from  Tour  to  twelve  feet  high. 
At  some  points,  marshes,  which  terminate  in  low  8wam|)s,   bor- 
der the  river  ;  over  which  the  river  road,  during  wet  seasons,  ii 
miry  and  almost  impassable  for  waggoqa.      Buffalo,  two  miles 
above  Black  Rock,  previous  to  the  war  was  a  considerable  vil* 
lage,  rapidly  increasing  in  population  and  trade,  beautifully  situ- 
ated on  n  creek  of  the  same  name.     At  the  time  it  was  burnt  by 
the  British  army  in  December,  1813,  it  comprised  between  one 
and  two  hundred  houses.  The  whole  of  the  thiuly  scattered  settle- 
m(?n{s  on  the  Niagara  were  at  the  same  time  |)illnged  and  burnt. 
Directly  op^tosite  Fort  Niagara,  on  the  Canada  side,  the  beauli- 
fid  village  of  Newark  presents  ilself  to  view.     The  whole  coun- 
try on  the  Canada  side  \&  under  a  good  state  of  cultivation,  and 
pleasant.      From  Newark,  after  passing  a  number  of  fine  farms 
and  settlements,  we  arrive  at  Qucenslown,  opposite  Lewistown. 
This  is  a  cliarniing  little  village.      An  adjoining  eminence, 
known  by  the  name  of  Queenetown  Heights,  commands  a  most 
fixtensive  [)rospect.      From  this  place  the  eye  comprehends,  at 
one  scoiJC,  the  whole  country  to  the  borders  of  Lake  Ontario 
north  distant  eight  miles,  variegated  with  woods  and  cultivated 
lauds,  and  to  the  village  of  St.  Davids  west  four  miles,  which 
j)rosper:t  overlooks  the  vast  toreals  beyond.     At  the  same  time  a 
full  view  of  the  Niagara  meandering  to  the  lake,  the  waters  of 
Ontario,  as  well  as  the  remote  high  lands  of  Little  York,  'Ustant 
Ibiiy  miles.     All  these  combined  render  this  a  most  delightful 
situation.     The  sceneries  from  this  elevated  ridge  will  enlarge 
and  extend;  and  for  many  years  will  become  more  and  more 
beautifully  picturesque,  as  improvements  progress.     Queenstown 
Heights  will  long  be  remembered  in  the  annals  of  history,  where 
the  first  imj)orlant  battle,  after  the  declaration  of  war,  was  fought 


[. 


iffrpfi^^^pwvi ^pi4Pi^ji^ 


CAMPAIGN  OP  18131  tfd 

On  ihe  Caftada  side,  between  a  small  body  of  United  States' 
troo|>s  and  New-York  volurteen,  under  the  command  of  Gener- 
al Van  Ranbclakr,  and  the  Britiah  under  the  command  oTGe^ 
neral  Rbock  ;  in  which  ill-conducted,  unfortun^xte  action,  unpro^ 
pitiouB  to  the  arms  of  the  United  States,  five  hundred  men  we:e 
either  killed  or  taken  prisoners  of  war ;  and  in  which  the  Brit- 
kh  General  lost  his  life. 

Lewistown  is  a  handsome  site  for  a  town,  the  name  of  which 
'*  only  bears,  comprising,  before  this  fronlie  *  wasdevasted,  a  few 
lug  houses.  Situated  as  it  is,  at  the  hend  of  navigation  of  T^ake 
Ontario,  it  will  become  a  place  of  importance,  as  a  deposit  for 
goods  transported  to  and  from  the  shores  of  the  lakes  west,  as 
well  as  the  country  east.  The  exuberant  productions  of  this 
fertile  country  will  here  concentrate.  The  portage  from  (lie 
navigable  waters  of  Ontario  to  Erie,  is  eight  miles. 

From  Lewistown,  as  we  proceed  south  up  the  Niagara,  an  em- 
inence isabrnptly  ascended  one  hundred  feet,  or  more,  above  (he 
tract  which  borders  Ontario,  and  more  than  one  hundred  nud 
nrty  feet  above  its  waters.  The  traveller,  when  climbing  this 
precipice,  feels  that  from  its  summit  he  would  find  a  descent 
somewhat  proportionate  to  the  ascent.  He  is  both  disappointed 
and  astonished  to  learn,  that  the  precipice  ascend*  *  is  but  the 
edge,  or  abutment  of  a  vast  and  exteimive  plain,  or  table  of  land, 
which  contains  within  its  enormous  excavation,  the  waters  of 
Erie,  three  hundred  miles  in  length,  and  one  hundreil  miles  in 
breadth,  which  disenabogue  themselves  from  Erie,  tiirougli  the 
strait  or  river  above  described,  to  Lake  Ontario. 

This  abutment  extends  east  a  great  distance,  and  with  some 
broken  inequalities,  gradually  loses  itself  in  lands  descending  in 
gentle  swells  from  the  south.  To  possess  a  correct  idea  of  the 
general  face  of  the  country  which  comprehends  the  waters  of 
Ontario  and  Erie,  it  will  be  nnderstcod  they  are  severally  con- 
tained in  two  vast  basins,  t;upported  in  two  extensive  plains,  OT 
pore  strictly  speaking,  gently  undulato  .ands.  One  ? f  which, 
with  an  elevation  of  one  hundred  and  tii'ly  feet,  seems  as  iflap- 
ped  on  the  lower,  while  the  waters  of  the  upper  arc  restruiued 
by  lands  on  the  north  the  distance  of  Lewistown  from  Lake 


■T^^mnmm^w^ 


% 


t 


i 

i  !t     ■ 


} 

i 

3 

j 

i 


|h 

j 

i 

It  ■! 
1    ' 

loo 


MEDICAL  SKETCHES. 


Erie,  bounded  by  the  above  described  precipice)  or  abutment. 
ThiB  abutment,  for  its  greater  security,  is  strengthened  by  lay- 
ers of  roclis  from  its  foundation  stratum  sttper  stratum,  coated  tvitli 
earth,  which,  through  a  long  series  of  ages,  has  been  washed  by 
rains  from  the  summit.  This  abutment,  after  being  divided  by 
JMiagara  river,  at  Lewistown  i^,  on  the  Canada  side  of  the  river 
from  Queenstown,  extended  ns  far  as  the  heights  of  Burlington, 
at  the  west -^rtremity  of  Ontario.  '  f     ■••/"' 

The  cataract,  eight  miles  south  of  Lewistown,  is  one  of  the 
wonders  of  this  continent.  To  give  a  just  descrifition  of  this  a» 
mazing  fall  of  water,  exhibiting  a  sheet  600  yards  in  width,  di- 
vided by  Goat's  island,  rolling  from  a  perpendicular  precipice  to 
a  vast  and  awful  chasm  150  feet  deep,  might  appear  a  vain  at- 
tempt after  the  very  correct  descriptions  which  have  been  al- 
ready published.  The  picture  of  this  sublime  natural  exhibi- 
tion, had  been  painted  in  a  language  so  picturesque,  its  reality 
to  my  view,  was  leas  majestic,  than  what  had  been  formed  on 
the  imagination.  Observations  similar,  have  been  expressed  by 
others  aftei  visiting  this  cataract. 

The  rapifla,  on  the  American  side  above  the  falls,  are  in  ex- 
tent half  a  mile.  Where,  in  broken  sheets,  the  waters  seem  in 
full  career,  white  with  foams,  down  a  huge  bed  of  broken  rocks, 
in  a  descent  of  50  or  60  feet,  bounding  over  crags  and  steeps, 
Avith  a  movement  accelerated  as  they  approach  the  brink 
of  the  precipice.  Above  these  rapids  tiie  river  is  two  miles 
wide,  where  the  waters  pressed  by  broader  torrents,  seem,  by 
their  impetuous  race  down  a  declined  plane,  to  be  accelerated  to 
unite  with  the  preceding  contending  floods,  in  one  tumultuous 
stunning  roar.  The  waters,  on  the  Canada  side,  in  their  course, 
perform,  with  increased  celerity,  their  race  to  meet  the  awful 
conOicting  scene. 

The  accumulated  body  of  water  on  the  Canada  side  is  so  for- 
cibly pressed  forward  by  floods  behind,  and  quickened  by  its 
movement  on  a  descending  plane,  and  accelerated  by  its  ov.n  vo- 
luminous weight,  as  it  approaches  the  cataract,  that  it  fhoots  over 
the  precipice,  forming,  at  the  distance  of  40  or  50  feet  from  its 
perpendicular,  a  curved  white  sheet.     On  the  United  States' 


■T^^wp^iPWUIH  U 


CAMPAIGN  OP  1813. 


101 


•!de,  the  water  fulls  in  a  thinner  perpendicular  sheet.  The 
grand  fidls  are  divided  by  Goat  island.  The  sheet  on  the  Ame- 
rica n  side  forms  au  angle  of  120  degrees  with  that  on  the  Cana- 
da  at  Goat  island.  r.    ;  ,.;    ..      ,  .  i       a  . » .. 

The  uninterrupted  conflicting  current  of  this  broail  cataract 
immediately  below  (he  falls,  exhibits  a  scene,  although  less  ma- 
jestic, still  more  awful.  From  this  thundering  precipitated  tor- 
rent, in  wild  commotion,  rises  a  foum  to  half  the  height  of  the 
precipice;  where,  intermixed  with  air,  the  lighter  sprays  are  sus- 
pended in  clouds  and  become  the  e|)ort  of  the  winds.  These 
clouds  are  seen  thirty  miles.  The  vast  sheet  of  water,  precipi- 
tated by  its  weight  to  the  t)ottom  of  the  gulph,  seems  lost  for  a 
short  time ;  then  swelling  from  beneath  the  superincumbent  wa- 
ters, bursts  u|>on  the  surface  in  spouts,  forming  figures  of  various 
and  cnanging  shapes,  which  move  in  every  direction,  and  in 
hurried  disorder  and  giddy  whirls  dance  upon  the  wave ;  while 
the  great  body  of  the  flood,  emerging  at  some  distance  below  the 
falls,  pursues  its  rapid  course.  Sixty  rods  below  the  falls,  the  ri- 
ver is  passed  in  a  small  boat  with  safety. 

With  wonder  we  view  a  mountain's  summit;  and  the  sublime 
precipice,  from  its  base,  affords  delight.  But,  when  we  oast  ouc 
eyes  down  on  deep  sounding  caverns,  or  on  yawnirg  broad 
chasms  below,  all  is  apprehension.  Our  heads  turn  giddy ;  w* 
tremble  in  every  joint;  we  seize  on  every  bush,  and  cling  to  ev- 
ery tree,  as  we  approach  the  brink ;  and  still  feel  we  may  be 
precipitated  in  a  moment  to  the  dreadful  gulph.  Such  is  the  force 
of  association  of  ideas,  that  the  body  irresistibly  becomes  the 
sport  of  its  influence. 

Two  miles  above  the  falls  the  Ghippawa  empties  its  waters. 
A  signal  victory  was  gained  over  the  British  army  at  this  place, 
5th  of  July,  1814,  by  a  detachment  of  General  Brown's  divi- 
sion, led  by  the  intrepid  General  Scott.  Four  miles  north  of 
Chippawa,  on  the  heights  of  Bridgewater,  the  25th  of  July  fol- 
lowing, was  fought  a  second  battle,  in  which  Generals  Brown, 
Scott,  Rii-ley,  Porter  and  Miller  were  conspicuously  en- 
gaged ;  and  in  which  there  was  exhibited  a  most  brilliant  dis- 
play of  undaunted  courage  and  cool  bravery  by  the  whole  armj* 

14 


■iS 


i:,! 


!,  1! 


'  1 

1 

t 

'i 

1 

■ ,' 

Iff 

■ 

■tf 

( 

1 

mm 


102 


MEDICAL  SIETCHES. 


m 


i!'f 


II 


; 


'    { 


After  Generals  Bboi»n  and  Scott  were  wonndeJ,  the  command 
devolved  on  General  Ripley,  who  with  n\  hundred  and  fifty  of 
hifl  own  brigade  and  volunteers  under  the  command  of  General 
Porter,  charged  the  British  line,  three  times  their  number,  and 
repulsed  it  at  every  point.  In  this  action.  General  Millbr, 
with  the  2l8t  regiment,  distinguislied  himself  in  a  particular 
manner,  by  a  charge  with  the  bayonet,  upon  a  battery  of  nine 
pieces  of  artillery,  which  fell  into  his  hands.  The  killed  and 
wounded  of  both  armies  were  great  for  the  numbers  engaged. 
Fort  Erie,  situated  opposite  Buffaloe,  will  ever  be  remembered 
in  history,  for  the  gallant  defence  made  by  General  Ripley, 
during  five  weeks ;  as  well  as  a  subsequent  repulse  the  enemy  met 
with,  when  he  assailed  the  works  defended  in  a  most  gallant 
manner  by  troops  under  the  command  of  Generals  Gaines  and 
Riptey;  also  on  account  of  the  successful  sortie  made  by  orders 
of  General  Brown  upon  the  enemy's  batteries,  which  compelled 
him  to  raise  the  siege. 

The  country  which  borders  the  Ontario  east  of  Niagara,  from 
eight  to  twelve  miles  from  its  shores  is  flat,  intersected  by  ra- 
vines,  at  distances  of  two,  four,  and  six  miles ;  formed  by  waters 
which,  in  times  of  rains  and  freshets,  run  from  the  high  lands 
south.  These  ravines  communicate  with  the  lake  by  creeks, 
which  originally  were  land-marks  of  distances  from  the  Niagara 
down  the  lake  shore ;  at  this  day  are  known  by  the  name  of  two 
miles,  four  miles  creeks,  according  to  their  respective  distances. 
The  same  mode  of  estimating  distances  from  Niagara  west  has 
obtained  on  the  Canada  side.  The  flat  lands  above  mentioned 
are  wet  into  mid  summer,  except  where  openings  into  the  forests 
have  been  made  for  cultivation.  These  improvements  are  nei- 
ther frequent  nor  extensive.  Not  over  four  or  five  years  had 
settlements  been  made  on  this  frontier  previous' to  the  war.  This 
tract  is  known  by  the  name  of  Holland  purchase. 

The  whole  of  this  territory,  comprising  a  diversity  of  soil,  has 
the  reputation  of  being  the  most  fertile  in  the  northern  states ; 
perhaps  not  inferior  to  any  in  America,  productive  in  all  kinds 
of  grains,  and  every  species  of  fruit  which  grow  in  New-England. 
The  meadows  particularly  are  luxriaat.    The  crops  of  wheat  on 


\1.  ' 


"¥ 


CAMPAIGN  OP  1818. 


103 


every  goil  are  abundant,  amply  remunerating  the  husbandman 
for  his  labor.  The  Torests  are  composed  of  large  and  lorty  beach, 
maple,  and  the  aspiring  elm,  interspersed  with  groves  of  nuyestic 
oaks.  ^ 

The  lands  in  the  vicinity  of  Port  Niagara,  and  on  the  borders 
of  the  strait  to  Lewistown,  were  very  wet  until  the  middle  of 
July,  in  1813j  in  consequence  of  repeated  rains,  when  the  weath>^ 
er  became  dry  and  hot.  The  waters  on  the  surface  of  the 
ground  soon  evaporate<l ;  the  roads,  hich  had  been  bad,  soon 
became  passable.  Transitions  from  cold  to  excessive  heat  were 
fN)  sudden  during  the  month  of  August,  that  to  me  it  was  almost 
insupportable ;  more  oppressive  than  had  ever  been  experienced' 
by  myself  in  the  atlantic  states. 

While  contemplating  the  above  wonderful  works  of  nature,| 
the  relative  positions  of  lakes  Ontario  and  Erie ;  the  elevation 
of  the  last  300  feet  above  the  former,  with  only  35  miles  of  in* 
tervening  distance ;  we  are  irresistibly  carried  back  to  remote 
antiquity; — a  period  when  w.e  wonderful  cataract  of  Niagara 
was  advanced  eight  miles  lower  on  the  strait  or  river.  If  any 
dates  were  obtained,  how  far  it  has  retroceded  in  a  given  nun*' 
ber  of  years,  a  tolerably  correct  calculation  might  be  made  at 
what  period  of  antiquity  the^^waters  rolled  over  the  abutment  at 
Lewistown ;  the  number  of  years,  also,  before  the  falls  will  re- 
cede to  the  northern  extremity  of  Erie,  the  present  outlet  of 
that  lake  f  provided  the  river  the  whole  distance  glides  over  a 
bed  of  rocks  to  the  cataract,  as  it  must  have  done  from  its  pres- 
ent position  to  Lewistown^ 

Such  are  the  evidences  of  this  statement,  the- spectator  must 
yield  to  it  his  assent;  while  the  philosopher,  upon  examining  the 
complicated  sceneries  on  the  Niagara,  will  advance  in  his  con- 
jectures one  step  beyond,  convinced  by  still  stronger  marks  of 
changes  having  taken  place  from  more  remote  antiquity  to  that 
period  previous  to  a  communication  between  Erie  and  Ontario ; 
when  the  northern  abutment  of  Erie  was  entire  and  its  waters 
disembogued  themselves  south  through  a  different  channel,  which 
held  intercourse  with  the  Mississippi.  He  will  be  also  forcibly 
impre89ed  by  evid«pce  demon»trative,  that  the  waten  of  Ontario- 


104 


MEDICAL  SKETCHES. 


1- 


V 


li 


!■:  1  I 


f     • 


have  retired  from  eight  to  twelve  miles  from  ita  most  ancient 
banks;  leaving  a  tract  of  alluvial  land  of  the  first  quality  once 
submerged,  now  covered  with  forests  of  suiierb  growth  and  capa- 
ble of  the  highest  cultivation.  U|)on  the  most  ancient  bank  of 
lake  Ontario,  which  is  im|)rovjd  as  a  road,  petrifactions  of  vari- 
ous species  of  water  sheila  have  been  dug  eight  feet  below  its 
surface.  Specimens  of  which  were  presented  me  by  colonel 
Barton  an  inhabitant  of  Lewislown.  These  without  other  ev- 
idence force  a  belief,  fhat  the  waters  of  Ontario  were  anciently 
seventy  feet  perpendicuiit.- above  their  pnsent  level.  The  lands 
vhich  Jiorder  Erie  exhibit  appearances  of  having  been  once  ov- 
erflowed with  water.  Rocks  and  stones  interspersed  through  the 
country  have  marks  cC  having  been  worn  smooth  by  wiiter  and 
sand;  in  some  of  which  are  found  imoedded  petrifactions  of 
shells.  These  are  demonstrations  that  the  above  lakes  were,  at 
some  former  period,  vastly  more  extensive  than  at  the  present. 

It  may  be  thought  a  bold  conjecture,  too  improbable  for  be- 
lief, to  say  the  river  Niag  na  is  of  modern  date,  compared  with 
the  most  ancient  state  of  the  lakes;  previous  to  a  water  commu- 
nication between  them,  v  Men  the  waters  of  Erie  with  the  lalies 
west  emptied  themselves  tbiwtigh  a  channel  south.     > 

To  seek  for  causes  of  an  obstruction  of  the  ancient  outlet  of 
these  waters,  previous  to  the  existent  Niagara,  an<l  account  for 
its  present  channel,  we  may  not  go  back  but  a  few  years  to  find 
one ;  similar  to  that,  but  more  powerful,  which  lately  overturned 
from  their  bases  extensive  banks  on  the  Mississippi  into  its  chan- 
nel. That  a  similar  concussion  has  either  tumbled  into  the  an- 
cient channel  of  the  outlet  of  the  waters  of  the  upper  lakes,  or 
raised  its  bed  so  as  to  obstruct  their  course  is  probable.  To  cor- 
roborate the  hypothesis,  it  is  stated  that  even  now  there  is  a  wa- 
ter communication  between  the  waters  of  the  upper  lakes  to  the 
waters  which  empty  into  the  Mississippi,  which  admits  of  l)oat 
navigation ;  through  which  the  baggage  of  a  detachment  from  a 
post  on  the  lakes,  was  transported  to  the  Mississippi  in  batteaus; 
that  the  route  was  through  a  champain  <  untry,  without  an  in- 
tervening hill.  The  last  statement  wab  given  me  by  the  com- 
raanding  officer  of  the  detachment.       ■■;;,,:,    .  i>x,c'*r 


\  ti  i 


CAMPAIGN  OF  1813. 


105 


A  BuddRii  accumulation  or  the  waters  not  onlf  of  Eric,  but 
the  upper  lakes  would  have  been  a  consequence  of  an  obstruc- 
tion or  its  most  ancient  outlet.  The  increasing  flood  would  con- 
tinu  illy  encroHch  upon  the  bordering  lands,  until  the  old  outlet 
was  opened,  or  a  new  one  formed  at  some  point ;  that  point  was, 
where  the  banks  o(  the  vast  basin  of  Erie  were  the  lowi38t.  ^uch 
being  the  state  of  the  waters,  at  this  ancient  period,  the  current 
of  the  overwhelming  flood  of  Erie  irresistibi/  forced  its  passage 
to  Ontario;  by  which  event  the  channel  of  Niagara  was  opened. 
Lake  Ontario,  extending  then  to  its  ancient  bounds,  exp^ienced 
an  increase  of  its  waters  from  Erie  through  its  recently  formed 
outlet.  What  were  the  consequences  of  the  rise  of  waters  in 
Ontario,  with  all  which  has  been  adduced,  are  conjectural;  ne- 
vertheless, the  present  appearances  warrant  every  suppositioa 
which  has  been  advanced. 

To  account  for  the  recession  of  the  waters  of  Ontario,  from  its 
ancient  banks,  an  additional  flood  was  necessary  to  accomplish 
go  great  a  work — an  enlargement  of  its  own  outlet  the  St.  Law- 
rence. It  was  not  only  the  accumulated  waters  of  Erie,  but 
those  of  Huron  and  Superior  with  their  tributary  streams  which 
aided.  The  channel  of  St.  Lawrence  deepened  and  enlarged  by 
these  overwhelming  floods,  as  soon  as  those  of  the  upper  lakes 
had  subsided  to,  or  probably  below  their  most  natural  level ;  the 
waters  of  Ontario  sunk  below  their  ancient  bounds,  as  the  St. 
Lawrence  was  necessarily  enlarged  and  deepened. 

In  consequence  of  the  increased  depth  of  the  St.  Lawrence, 
lake  Champlain,  communicating  with  it  by  the  Sorel,  experien- 
ced a  similar  recession  of  its  waters  from  its  ancient  banks. 
There  is  presumptive  evidence  that  all  the  high  plains  on  its 
borders,  extending  to  the  mountainous  parts,  were,  at  a  very  re- 
mote period  of  time,  submerged.     (See  Note  G.) 

Some  point  on  the  Niagara  frontier  will,  one  day,  become  the 
grand  emporium  of  this  north-western  territory.  If  we  may  be 
allowed  to  form  an  opinion  from  the  existent  astonishing  im- 
provements, that  period  is  not  very  remote.  The  fertility  of  the 
soil  not  excelled  by  any  f  .  ae  United  States,  intersected  by  riv- 
ers capable  of  boat  navigatioo,  bordering  on  inland  waters  not 


It 


Is  ft!  I 


.   I 


i 
II 


If/    J 


10* 


MEDICAL  SKETCHES. 


■r^'< 


mi 


Hii 


if;  i  > 


;.^!! 


inferior  in  extent  to  seas,  navigable  for  vessels  of  the  largest  bur* 
thens,  and  possessing  the  advantages  of  a  navigable  comtnunica> 
tiop,  excepting  the  short  distance  of  seven  miles,  with  the  At- 
la:  tic  ocean,  will,  within  a  few  years,  be  capable  of  affording  to 
the  nation  resources  which  may  rival,  and  even  surpass  those  of 
the  Atlantic  states  of  the  same  extent  of  navigable  waters. 

This  is  not  a  mere  speculative  suggestion,  nor  a  wild  antici< 
pation  of  an  extravagant  imagination.  The  sentiment  admits 
of  actual  demonstration.  This  tract,  embracing  an  extent  from 
Utica,  near  the  source  of  the  Mohawk,  to  Buffalo,  the  east  extrem  • 
ity  of  Lake  Erie,  thence  to  Detroit,  a  length  of  five  hundred 
miles,  and  a  width  of  150  to  200,  twenty  years  previous  to  the 
lata  war,  was  a  wilderness  unfrequented  by  civilized  man.  But 
at  the  present  period  many  parts  of  it  are  in  the  highest  state  of 
cultivation.  New  towns  and  villages,  which  in  point  of  popula- 
tion equal,  and  of  ornamental  appearance,  surpass  the  ancient 
villages  in  the  Atlantic  states,  are  interspersed  amidst  the  vast 
forests  of  this  district. 

Should  we  ca^t  our  eyes  stil  further  west,  and  look  only  a  few 
years  into  futurity,  we  shall  see,  by  anticipation,  settlements  no 
less  important  on  the  waters  of  the  Michigan,  and  even  to  the 
western  extremity  of  Superior ;  when  a  commerce  will  necessari- 
ly require  vessels  whose  aggregate  of  tonnage  will  not  be  less 
than  that  on  the  whole  Atlantic  shores.  < 

What  is  there  to  prevent,  if  luxury  and  thirst  of  opulence 
keep  pace  with  Improvements  ?  The  soil  of  this  district,  being 
much  superior,  is  capable  of  supporting,  on  a  territory  of  equal 
magnitude,  a  population  vastly  more  numerous  than  that  in  the 
Atlantic  states  can.  The  productions  of  the  earth,  with  the 
same  labor,  are  three  and  four  fold. 
'  A  free  navigation  of  these  waters  to  the  ocean  would,  even  at 
this  period,  be  of  infinite  importance  to  the  United  States,  while 
the  consequences  of  the  natural  advantages  which  this  territory 
possesses  will  increase  with  the  population  of  the  country. 

To  possess  a  correct  opinion  of  the  value  of  this  country,  which 
the  command  of  these  western  lakes  and  rivers,  communicating 
tvith  the  Atlantic,  would  give,  the  parts  pf  the  whole  district  ijyt 


!/  ^li 


■  n^JKIV  • 


CAMPAIGN  OP  1813. 


107 


relation  to  each  other,  and  the  extent  of  an  inland  navigation 
iatimately  connected  mth  a  foreign,  must  be  viewed.  The  pol- 
itician cannot  be  convinced  with  any  representation  short  of  oc- 
eular  demonstration.  While  in  his  closet,  with  even  <i  correct 
map  of  the  country  before  him,  he  can  acquire  but  an  imperfect 
Hlea  of  the  immense  wealth  it  will  in  a  few  years  afford.  'It  is 
anticipated,  thnt  one  of  the  (■"reatesl  sources  of  the  national  rev- 
enue  may  he  the  commerce  of  the  north-western  district ;  but 
which,  while  Canada  .j  possessed  by  the  British  government, 
may  not  pay  the  expenses  of  collection.  Under  existent  circum- 
stances, at  peace  with  Great  Britain,  innumerable  avenues  will 
be  open  for  smuggling,  which  may  be  carried  on  to  such  an  ex- 
tent between  Canada  and  the  north-western  territory,  as  not 
only  to  diminish  the  public  resources,  but  render  them  subservi' 
ent  to  the  British  government. 

The  inhabitants  of  the  northern  and  western  parts  of  New- 
York  are  mostly  emigrants  from  the  New-England  states.  The 
fertility  of  the  soil  of  this  district  invites  enterprising  adventurers 
to  those  regions ;  where  the  laborer  is  amply  remunerated  for 
his  toils,  while  changing  the  face  of  the  earth,  and  converting  the 
wilderness  into  pleasant  cultivated  fields.  '  t 

It  is  that  class  of  people  generally,  who  are  endowed  with 
good  educations,  that  first  adventure  into  this  territory.  They 
possess  not  only  high  degrees  of  resolution  and  industry,  but  a 
knowledge,  which,  by  inductions  drawn  from  causes  and  their 
effects,  leads  them  to  foresee  the  future  importance  of  this  terriv 
tory. 

The  traveller,  on  his  journey  through  this  district,  is  astonisB^ 
ed  to  find  so  large  a  proportion  of  its  inhabitants  well  educated. 
There  are  at  this  period  more  men  possessing  literary  informal 
tion  to  be  found  in  these  new  settlements,  in  proportion  to  theic 
population,  than  in  the  old  towns  and  villages  of  New-England. 
These  emigrants  from  the  old  states  bring  with  them  habits  of  in- 
dustry necessarily  acquired  in  a  country  where  a  man,  to  eujoy 
the  blessings  of  life,  must  be  indefatigable  in  the  employment  ia 
which  he  is  engagedL  - 


14 


\w 


MEDICAL  SKETCHES. 


m 


m 

!   I    I 


I 


111 

I 

A 


The  marki  of  a  stronr;  attachment  to  the  religion  of  their  an* 
cettMriare  exhibitetl  by  beautiful  ediBces  d  nlicated  to  the  Lurd. 
In  every  village  areicen  buildings  for  public  woniiiii),  highly  on 
namental.  Having  experienced  themselves  the  benefits  of  an 
early  education,  they  know  how  to  appreciate  its  value;  anu  are 
therefore  not  inattentive  to  furnish  the  means  of  literary  acquire^ 
ments  for  the  rising  generations.  In  every  village  are  found 
schools  where  the  first  rudiments  of  letters  are  taught  by  classic 
scholars.  In  many,  also,  are  seen  seminaries  of  learning  and 
academies,  in  which  the  higher  and  more  important  branches  of 
literature  may  be  acquired. 

What  are  the  motives  which  induce  the  inhabitants  of  the  old 
towns  to  quit  the  places  of  their  nativity,  and  leave  connexions 
and  friends,  to  commence  new  settlements  in  a  wildermss  !  has 
frequently  been  asked.  The  acquisition  of  a  more  comfortable 
subsistence,  and  accumulation  of  wealth.  These,  the  main 
springs  of  action  in  social  life,  inspire  a  n^an  with  courage  and 
fortitude  to  embark  in  vast  enterprises — to  endure  fatigues — to 
submit  to  privations — and  encounter  dangers. 

Great  undertakings  are  meritorious,  when  they  promote  the 
interests  of  the  public,  and  enlarge  the  sphere  of  private  happi* 
nesf.     It  is  then  they  deservedly  receive  universal  applause. 

The  "  wilderness^'  cannot  "  blossom  like  a  rose,"  wiihout  the 
nid  of  man ;  who  must  encounter  difficulties,  and  undergo  infinite 
toils.  With  clieerfulness  and  patience  these  are  endured  by  the 
first  settlers  of  a  country  ;  from  whose  soil  its  resources  are  not 
evolved,  except  by  indefatigable  industry  and  persevering  Ip' 
hour.  By  these  means  it  is,  the  liardy  husbandmdn  of  the  for- 
rests  accumulates  riches  in  these  fertile  regions,  from  the 
productions  of  his  farms ;  the  mechanic,  from  his  ingenuity  and 
unremitted  attention  to  his  occupation,  increases  his  wealth;  and 
the  merchant,  by  his  accurate  and  economical  calculations,  en* 
larges  his  fortunes. 

•  The  northern  and  western  frontiers  of  New-Tork,  like  all  new 
countries  emerging  from  a  wilderness  state,  are  more  unhealthy 
than  the  old  settled  towns  in  the  same  latitudes  in  the  New* 
JBngland  states.     A  country  in  a  state  of  nature,  previous^  to  op- 


-^rimi^^mmrmmmm^mf'it^fyw^n'^Jf^^ 


CAMPAIGN  OP  1813. 


109 


enin{;8  for  cultivation,  is  less  suliject  to  diseases  than  the  same 
district  after  improvemrnts  are  commenced  l»y  the  aj;riculturist. 
Hunters  and  surveyors  of  woodlands,  exposed  during  many 
months  to  all  the  vicissitmles  of  weather,  with  little  or  no  shel- 
ters from  cold  storms,  seldom  suffer  from  diseases.  The  ahorigi- 
nes  experience  fewer  diseases,  than  the  inhabitants  of  new  set- 
tled countries.  .i  _  ,      ,     ,,     ]   ,     ,  j ,,; 

Upon  opening  a  farm  in  the  midst  of  a  wilderness,  the  putrefac- 
tion of  vegetable  substances  is  promoted  in  higher  degrees  by  the 
increased  rays  of  the  sun  upon  the  surface  of  the  recently  ex|)os- 
ed  earth,  during  the  hot  seasons  of  the  year.  The  deleterious 
gnsses  emanating  by  the  process  of  putrefactive  decomposition 
are  suspended  over  the  cultivated  spot  in  greater  or  keg  propor- 
tions, as  currents  of  air  are  impeded  by  surrounding  forests.  Un- 
der these  circumstances,  heat  and  moisture  are  not  eva|)orateil 
iD  proportion  to  their  extrication  from  the  earth ;  while  the  in- 
habitants are  enveloped  in  a  warm  vapour  bath  charged  with  of- 
fensive gasses,  eliminated  from  substances  in  a  state  of  decay, 
by  which  they  are  predisposed  to  diseases,  and  suQer  from  them 
more  or  less,  as  artificial  cau-es  co-operate  to  excite  the  diseased 
actions.  Severe  labor  under  a  hot  sun ;  a  neglect  of  cleanliness 
in  log  houses — habitations  of  the  first  settlers ;  a  coarse  diet,  ilE 
adapted  to  easy  digestion  and  nourishment,  as  meats  fryed  in  fat, 
instead  of  being  boiled,  or  prepared  in  the  form  of  soups;  and  ar- 
dent spirits  of  the  wors(  quality — new  rum  and  whisl^ey,  ar« 
among  the  co-operating  causes  productive  of  diseases  in  ne\t 
settlements. 

In  proportion  as  cultivation  of  the  earth  is  extended  by  opea-r 
ing  the  forests  and  draining  the  lands,  so  will  climi^te  be  improve 
ed,  and  its  endemic  diseases  disappear.  The  heavy  fogs  of  lakes 
and  large  rivers,  which  are  impeded  and  suspended  over  their 
borders  by  woodlands  until  a  late  hour  of  the  day,  abstract  from 
the  body  its  vital  heat,  and  subject  the  inhabitants  to  intermit* 
tent  fevers,  and  other  autumnal  diseases,  as  dysentery  and  diav^ 
rhoea.  They,  however,  are  less  frequent  at  those  points,  on  the 
lake  shores,  where  cultivation  has  made  some  progress,  and  have 
iisappeared  where  the  lands  are  extensively  improved*  These 
U 


ji  jHlnai'    ..(i 


'4 


m\ 


fit 


MEDICAL  SKETCHES. 


■ii 


autumnal  (lisensos,  whicli  nre  now  coniiulerRil  endemfc  in  new  aeN 
tlementB  on  the  frontiera,  will  vaninli  no  the  ToreslB  are  snlMlned, 
and  the  mnrehrs  nnd  awnrnps  (Irained  ;  while  tht*  huniiiindman 
will  be  remunerated  Uy  a  Iwo-fold  reward^— higher  degrees  of 
health,  as  well  as  nroumulation  of  wealth. 

The  transitions  of  weather  on  the  northern  and  western  front- 
iers are  less  frequent,  and  not  so  sudden  and  great,  as  on  the  At- 
lantic shores.  With  the  same  extensive  improvement,  their  in- 
habitants will  not  he  8courfi;ed  by  diseases  more,  than  those  oTthe 
eastern  states  ;  the  tirst  settlers  of  which,  (if  historians  and  the 
most  aged  of  the  iuhaliitauts  are  to  he  credite<l)  were  subjected 
to  the  same  diseases,  which  nre  now  endemic  on  the  north-west- 
etn  territories.  Intermittent  fevers,,  one  hundred  years  ago, 
were  common  in  the  lower  towns  of  Massachusetts,  where  a  sin- 
gle case  has  not  been  known  to  have  originated  within  the  past 
fifly  years.  The  few  autumnal  fevers,  which  are  sporadic,  gen- 
erally, may  he  traced  to  well  known  exciting  causes,  indepen- 
dent of  atmospheric  influences  arising  from  local  positions. 

The  diseases  of  winter,  in  the  northern  and  western  districts 
of  New-York,  are  mostly  pneumonia  of  every  grade  from  a  slight 
cough  to  high  inflammation.  The  most  severe  form  of  this  dis- 
ease prevailed,  during  the  war,  among  the  inhabitants,  as  well  as 
soldiers  of  the  army,  and  wm  no  less  fatal  to  the  first,  than  the  last. 
These  complaints  of  the  breast  are  seldom  seen  among  that  class 
of  citizens  the  most  temperate,  especially  its  severest  forms  ;  but 
among  those  who  indulge  in  a  free  use  of  wiiiskey  and  rum. 

The  means  employed  to  obviate  the  deleterious  effects  of  cold 
become\he  exciting  causes  of  dienses.  Long  exposures  to  in- 
clement weather  exhaust  the  excitement,  and  waste  the  vital 
principle.'  To  remove  unpleasant  sensations,  a  gill  of  whiskey 
is  resorted  to.  The  stomach  may  be  charged  with  three  or  four 
of  these  potations,  with  the  best  intentions  to  fortify  the  bo<ly 
against  disease.  A  cough,  increase  of  heat,  pain,  and  perhaps 
high  degrees  of  inflammation  may  be  the  consequence.  The 
whole  of  this  indisposition  may  have  been  obviated  by  tepid 
drinks,  or  a  soft  diet.  •      -  :  >       >ro. 


/ 


A 


»P^^»WPP»  ■  I II       li||J.»»<l 


CAMPAIGN  OP  1819. 


Ill 


Although  Incni  ixwitiuiii  innuvncf  the  statri  of  henlth,  and 
|ire(lifl|»o8c  lu  diut.MSts;  yet  cniiti«'s  which  may  be  dt'iiomiiialRd 
artifiriiil  excite  the  greatest  mimhcr  which  exist.  A  luhoriout 
man,  re|ih-te  with  Ixaith,  seidum  helieveg  the  oliservance  ufrulei 
and  regul.'ilioMB  of  temi*ennc«  is  necrsaury.  AVhile  he  is  free 
from  paiHi  he  v'  ws  discNise  nt  a  d^islance— with  a  liottle  ufwhii* 
ke  in  his  hand,  he  I)i(l8  defiance  to  death  ;md  its  terrors.  Id' 
stances  like  this  are  rretjuenl ;  wit!)  wliich  every  physician  is 
conversant.  Tin  Ibllowing  anecdote  is  not  a  ficticious  picture, 
but  a  painting  from  the  life.  ■ 

I  was  once  called  to  visit  a  child  whose  father  was  ab- 
sent when  taken  sick,  liefurc  my  prescription  was  m:ide,  he  re- 
turned ;  when  petulantly  aHkinc;  his  wife  why  a  physician  was 
called,  said,  he  consulted  no  physician,  and  took  no  drug;  that 
his  bottle  was  his  only  physician,  and  rum  his  only  nudidne. 
Runt  to  him  was  all  in  all,  as  it  cured  every  disease.  My  reply 
to  th>8  devotee  of  Hacchus  was,  that  rum  to  him  was  a  f;ood god. 
Not  many  days  had  passed,  when  this  mivn,  being  attacked  with 
a  violent  pain  in  his  side,  the  etfect  of  severe  labor,  and  lib- 
eral potations  of  spirits,  under  the  rays  of  a  hot  sun,  sent  for 
me  in  haste.  My  astonishm>'nt  was  expressed  he  should  cull 
the  aid  of  a  physician,  having  his  IDOL  at  hand  ;  affecting  to 
be  unwilling  to  prescribe,  when  I  had  so  potent  a  DEITY  as  a 
competitor ;  from  whose  assistance  he  had  heretofore  experienced 
so  much  benefit.  The  man  was  tantalized  until  confession  was 
extorted,  he  had  tried  his  favorite  medicine  without  good  effect, 
and  in  vain.  This  was  too  evident  to  have  been  mistaken. 
An  acknowledgment  of  the  fact  only  was  required.  As  soon 
as  he  was  convinced  of  his  folly,  the  requisite  means  to  mitigate 
distress  were  administered. 

Intermittent  fevers,  dysentery,  diarrhoea  and  jaundice  may  be 
considered  the  endemic  diseases  of  this  frontier.  Jaundice, 
however,  is  most  generally  a  secondary  disease,  subsequent  to 
iotermittents  and  diarrhoeas,  frequently  accompanied  with  an 
enlargement  of  the  liver.  Rheumatism  and  rheumatalgia  are 
also  common :  they  attack,  during  the  cold  seasons  of  the  year, 
those  who  indidge  in  the  use  of  ardent  s^tirits.    This  i&sufficieiit 


11 


!■■ 


'/iTT. 


n 


lie 


MEDICAL  SKETCHES. 


evidpncc,  (hnt  ihvnv  liqiiorH,  lakpn  to  excrss,  do  nol  oDvinto  dii- 
intcn,  bul  arc  highly  injurious.  As  8|»rinj;  o|>niB,  l»y  Ihr  gonial 
iniluences  or  th«  nun,  (hn  hist  iliwonscs  liisiipiieHr.  'I'his  fict  de* 
inouslralfB,  that  the  excitement  ot'spiritH  is  more  deleterious  t« 
animni  life  during  the  cold,  than  (he  hot  seasons. 

The  several  tyjies  of  fever  H|»|iear  under  more  nggrnvaled  formi 
on  the  north-western  frontiers,  than  in  the  New-Ung'aml  slates, 
under  the  same  latitudes.  The  greater  humidity  of  the  atmos- 
phere, in  the  viciwity  of  the  lakes,  comldned  with  the  hurtful 
*\gentB  licretofore  enumtrated,  is  assigned  as  a  cause. 


Jill  i 


^■^  1 


Thb  last  week  of  Novemher,  I  departed  from  the  Niagara 
frontier,  to  follow  the  divsion  of  General  Wilkinson.  After 
leaving  Williamaville,  thirty  miles  east,  we  arrive  at  Batavia,  a 
new  well  built  village,  surroundei!  with  farms  extensively  0|)en- 
ed,  comprising  a  soil  of  the  best  quality.  The  village  contains 
40  houses,  a  hantlsome  court  house.  Jail  and  a  county  arseiial. 
It  is  a  place  of  consulerable  business.  Over  a  tract  of  territory  of 
20  miles  square  within  the  limits  of  the  town,  according  to  the 
census  of  1810,  there  are  3645  inhabitants.  The  head  branches 
of  Tonnewonta  river  rise  in  this  town,  which  running  west  em[)- 
ties  itself  into  the  Niagara,  ten  miles  north  of  Black  Rock.  On 
this  river  is  a  town  of  the  Seneca  Indians.  This  village  is  sit- 
uated 256  miles  west  from  Albany.  Ten  miles  east  lies  Le  Roy 
Tillage,  comprising  30  houses  in  the  town  of  Caledonia,  -Avhich 
has  a  population,  by  the  census  of  1810,  of  2353  inhabitants, 
^^his  village  is  246  mill  Vom  Albany;  the  Genesee  river  is  its 
eastern  boundu/y,  where  commences  that  stupendous  work  of  na^ 
ture,  which  extending  to  Lewistown,  distant  76  miles,  forms  the 
grtat  barrier  or  abutment,  which  confines  the  waters  of  Erie  in 
its  own  basin,  excepting  a  breach  which  has  been  made  through 
it  by  Niagara  river.  This  ridge,  throughout  its  whole  distance, 
overlooks  the  alluvial  lands  which  border  Ontario,  and  when  the 
forests  are  cut  down  for  cultivation,  will  command  more  beauti- 
fol  uointerrupted  sceneries  than  can  be  found  perhaps  in  the 


if  i 


.^l 


CAMPAtON  OF  1«13. 


II  "mmin^f»^r»»^wi»i 


\Vi 


known  worM.  The  county  of  Oenesee  betwern  forty  nn<»  fifty 
mil^-B  Bt|imre,  14  yenrs  niroa  wildprnpn,  contninn  a  po|iiilHl!nn,  liy 
Ihe  ceriBiiB  of  1810,  of  12,044  inhnliitnntii,  nml  n  taxnble  |iro|iRrw 
ty  of  ll«p«'P  millioriB  of  ilollnra.  (Joni'BPe  rivrr  is  <li»triiit  il'J6 
milt'B  weBt  from  Alliany.  From  ChI»mIoii1ji,  Hfter  iinBuine  "'"W 
■otllemcnlB  nn«l  some  InconBHleruMe  villniiPB,  we  arrive  at  Illooin* 
fiel«l,  a  |)0|iiiloiiB  wrll  Bettle<l  town,  in  wliich  nre  highly  improv- 
ed fitrmB.  The  soil  is  of  the  first  qunllly,  ,iro<lurtive  of  every 
specieB  of  ^riiin,  grnsB  anil  fruit  lieeB.  Their  diiiries  furniflh  Uxr^e 
gupplies  of  butter  'mkI  cheese  for  market.  Domestic  muiufiiQlo* 
ries  of  cloth  are  c  -ried  on  to  conslrleralile  extent,  in  which  are 
employed  between  two  and  three  hundretl  looms;  in  IRK),  by 
the  census,  the  town  contained  4425  inhabitants.  During  the 
war  the  inhHliitnnts  of  this  lown  and  its  vicinity  found  in  the  ar- 
my an  excellent  m  irket  for  the  surplus  productions  of  their  farms. 
On  the  Niagara  tlieir  cheese  sold  for  60  cents  per  pound,  buller 
40,  cyder  8  dollars  per  barrel,  potiitoes  from  2  to  4  dollars  per 
bushel,  onions  from  2  io  4  dollars  per  bushel,  and  other  articles 
in  the  snme  ratio. 

The  next  place  of  considerable  "ote  is  Canandalp;ua  villae^e, 
situated  near  the  outlet  of  a  lake  of  the  same  name,  208  mib'S 
vrestfrom  Albany  and  1 1I  from  Utica.  This  villaG;e  is  built  on 
the  lake  hill,  vrhich  rises  from  the  shore  by  a  gentle  ascent,  and 
commands  an  extensive  view  of  the  lake  thirty  miles  in  length, 
and  the  handsome  improvements  on  its  banks.  In  1810,  by  the 
census,  it  contained  137  houses  and  stores,  county  buildings,  an 
elegantly  built  academy,  a  spacious  arsenal,  and  several  sufterb 
private  seats,  in  point  of  elegance  and  taste  inferior  to  none  in 
the  United  States.  Twenty  years  previous  to  the  war,  the  first 
house  was  erected  here  from  logs,  which  were  felled  to  make  an 
opening  for  the  house.  Since  which  it  has  increased  in  an  aston- 
ishing manner.  The  academy  is  richly  endowed— Messrs.  Goa 
HAM  and  Phelps  are  among  its  most  liberal  benef  ictors.  Ca- 
uandaigua  is  esteemed  by  travellers  the  most  beautiful  inland  vil- 
lage in  the  United  States.  Progressing  east  16  miles  from  the 
last  place,  we  arrive  at  Geneva,  192  miles  west  from  Albany, 
within  the  town  of  Seneca,  elegantly  situated  ou  tlie  west  bank 


'Hill 


«.♦■ 


r 


I 


r,i 


IH 


' 


■TtTfMwn" 


fill 


ii 


J  Hi 


114 


MEDICAL  SKETCHES. 


of  Seneca  lake.     It  is  a  place  of  conaiderahle  trade,  liavinfc  130 
houses,  3  places  of  public  woreiiip,  and  4  public  schools.     The 
soil  on  the  borders  of  this  lake  is  excellent  and  under  good  cul- 
livalion.    Geneva  is  about  25  miles  souUi  of  lake  Ontario.    The 
population  of  this  town,  by  the  census  in  1810,  was  3431.  While 
continuing  our  route  through  a  country  having  more  extensive 
improvements  and  greater  population,  we  arrive  at  Cayuga  lake, 
which  is  passed  over  on  a  very  handsome  bridge,  one  mile  in 
length ;  at  the  east  end  of  which  we  enter  the  village  of  the  same 
name.     From  which  position,  the  country  bordering  the  lake 
presents  a  great  variety  of  beautiful  scenerios,  variegated  from 
low  banks  gently  ascending  to  bolder  swells  from  100  to  200  feet 
in  height.     The  lake  discharges  its  waters  at  the   north  end, 
where  it  soon  meets  the  waters  from  Seneca  lake,  through   the 
river  of  the  same  name ;  thence  continuing  their  winding  course 
disembogue  themselves  into  lake  Ontario,  distant  25  miles.  The 
lands  are  rich  and  fertile.     Seneca  lake  is  38  miles  long,  and 
from  1  to  4  miles  broad.     Cayuga  village  is  in  the  town  of  Au- 
relius,  175  miles  west  from  Albany.     This  town  has  a  popula- 
tion, by  the  census  in  1810,  of  4642  inhabitants.      Its  inhabi- 
tants are  cultivators  of  the  soil,  and  if  we  may  judge  from  ap- 
pearances, generally,  and  jiarticularly  the  state  of  cultivation  and 
improvement,  all  of  which  have  been  made  the  last  20  or  25 
years,  we  must  infer  that  they  abound  not  only  in  the  necessa- 
ries and  conveniences  of  life,  but  in  the  luxuries,  sources  of 
wealth  and  opnlence.     After  leaving  Cayuga  village,  we  pass 
Camillus,  and  fine  farms  under  good  cultivation,  when  we  arrive 
at  Onon'Viga  hill,  to  distinguish  it  from  a  village  two  miles  east, 
in  the  hollow ;  the  first  contains  40  houses ;  here  the  county 
courts  are  held;  the  last  village  contains  60  houses,  in  which  is 
an  elegant  meeting-house.      Three  miles  south,  is  the  residence 
of  part  of  a  tribe  of  200  in  number,  anciently  known  by  the  name 
of  Onondaga  Indians.     Onondaga  is  50  miles  west  of  Utica  and 
147  miles  west  of  Albany.     From  this,  east,  we  pass  Manlius, 
137  miles  west  of  Albany.     This  town  like  others  already  no- 
ticed on  this  route,  exhibits  riches  an'  increasing   affluence. 
The  populatioh  consists,  by  last  census,  of  8127  iohabitauts. 


f 
I 


CAMPAIGN  OP  1813. 


nt 


From  this  to  Utica,  a  distance  or  forty  miles,  to  a  person  who 
had  heeo  twelve  months  conversant  with  vast  forests  and  new 
villages  ioterspered  in  the  wilderness;  the  increasing  improve- 
ments of  the  country  are  peculiarly  interesting.  New  objects 
and  changing  sceneries  continually  unfold  themselves.  Every 
mile  oii  the  route  prettents  older  states  of  cultivation,  where  in- 
creasing elegance  is  displayed ;  which,  had  the  Journey  been  re> 
versed,  and  the  traveller  immediately  from  the  Atlantic  shores, 
he  would  have  viewed  new,  as  being  less  improved.  Thus,  the 
mind  is  vario  v  and  oppositely  affected  by  the  same  objects. 
What  renders  the  most  remote  new  settlements,  when  first  be- 
held, more  astonishing  is,  they  are  approached  through  an  uncul- 
tivated wilderness,  'Ireary  to  the  lonely  traveller ;  and  while  his 
mind  is  shrouded  in  darkness  proportionate  to  the  gloomy  shades 
of  the  forests,  which  bend  over  his  head,  the  cheering  light  of  aa 
open  country  suddenly  bursts  upon  his  eyes ;  the  extensive  im- 
provements before  him  announce  a  village  near,  in  which  he  ex- 
pects to  find,  knowing  its  recent  date,  a  few  ,og  houses,  or  more 
decent  comfortable  habitations  covered  with  boards.  But  this 
exhilarating  light,  as  of  a  new  world,  with  mansions  of  painted 
wooil  work  and  bricks,  erected  with  taste,  and  in  an  elegant  style 
of  modern  architecture,  rich  and  superb,  astonishes  the  beholder. 

These  enlivening  sceneries  are  more  extensively  upened  as  we 
approach  Utica  from  the  west.  The  transition  is  not  less  pleas- 
ing than  the  Elysian  fields  were  to  Mneas,  after  traversing  the 
dismal  regions  of  Avernus. 

Upon  my  arrival  at  Utica,  information  was  obtained,  that  the  flo- 
tilla conveying  the  army,  instead  of  crossing  the  St.  Lawrence  to 
Kingston,  as  had  been  expected  by  those  unacquainted  with  the 
real  design  of  this  expedition,  had  directed  its  course  down  the 
St.  Lawrence ;  having  now  evitlently  for  its  object,  the  reduction 
of  Montreal.  The  disappointment  was  universally  felt  and  ex- 
pressed by  all  not  immediately  connected  with  the  army.  My 
own  feelings  compelled  me  to  concur  with  the  prevailing  public 
opinion,  that  the  campaign  of  this  year,  which  had  early  opened 
with  flattering  prospects — prospects  propitious  to  our  arms,  un- 
der the  command  of  General  DparborNj  would  close  with  irrepar- 


) 


Ih'I 

Wi:| 

J   J 

M'i 

^P^l 

ISMI 


'..  > 


11« 


MEDICAL  SKETCHES. 


i 


%    ' 


1 


lis 


able  (HsTistera ;  productive  of  disappointment  mortiryine;  to  nation* 
al  feelings,  as  well  as  lasting  disgrace  to  the  projectors  of  the  ex* 
pedition.  Little  is  hazarded,  when  it  ia  declared,  this  unfortun* 
ate  movement  of  the  army  was  made  in  direct  opposition  to  the 
sentiments  and  opinions  of  the  major  part  of  the  officers  of  the 

army.         ■»■•  ■''  ■  , :—  ^'    •    .  ■     .    '  .  ■■  ^ ••  v  ■'•  ^r-,;  - 

The  road  from  Utica  direct  to  Montreal  was  bad,  and  the  ac- 
commodations worse.  It  was  expected,  at  the  last  place,  or  some 
otiier  point  between  Ogdensburgh  and  Chateaugay,  the  army 
might  take  a  position.  Having  been  advised  the  enemy  had, 
in  some  instances,  crossed  small  parties  upon  the  south  bank  of 
the  St.  Lawrence,  in  the  rear  of  our  army,  during  its  progress 
down,  and  some  hazard  apprehended  from  these  marauders,  a 
more  circuitous  route,  by  Albany  and  Lake  Champlain,  was  pur> 
sued.  After  this  unpleasant  journey  of  nearly  five  hundred 
miles,  I  arrived  at  Plattsburgh  the  first  week  of  December; 
where  an  effort  was  made  to  place  the  hospitals,  now  in  extreme 
disorder,  under  some  regulations.  In  the  execution  of  which 
duty,  many  obstacles  pr^-ented  themselves,  while  the  division 
of  General  Hampton,  still  in  tents,  were  occupied  in  erecting 
their  1  arracks.  The  requisitions  upon  the  Quarter  Master  Gen- 
eral's department  were  so  pressing  to  furnish  materials  for  bar- 
racks, little  or  nothing  adequate  to  the  erection  of  hospitals,  could 
be  obtained.  My  most  pressing  ren'onstrances,  for  the  neglect 
of  the  hospital  department,  were  not  or  could  not  be  regarded,  so 
long  as  the  barracks  for  the  troops  were  considered  the  primary 
object.  The  first  consideration,  with  officers  of  every  grade, 
should  be  to  provide  comfortable  accommodations  for  their  sick. 
The  healthy  and  robust  can  better  endure  exposures  to  cold  and 
inclement  seasons  in  tents.  Under  these  comfortless  coverings, 
many,  enfeebled  by  diseases,  who  might  have  been  preserved, 
in  wanner  habitations,  were  daily  sinking  to  the  grave.  At  this 
period,  the  lOth  regiment,  the  only  one  from  south  of  Delaware 
at  this  post,  suffered  extremely  by  the  prevailing  mortality.  The 
disease  was  similar  to  that  of  the  preceding  winter.  My  stay 
here  was  of  too  short  duration,  to  form  an  opinion  of  the  practice 


CAMPAIGN  OP  1813. 


lif 


adopted ;  more  especially,  as  the  most  of  my  time  was  employed 
to  provide  more  suitable  quarters  for  the  sick  of  this  division. 

Orders  received  from  General  Wilkinson,  (who  had  then  tak- 
en quarters  at  Malone,  eighteen  miles  south  of  French  Mills, 
and  fifty  miles  from  Plattsliurgh)  hastened  my  departure  for  that 
place,  where  1  reported  myself  the  15th  of  December. 

The  General  had  contemplated  to  establish  hospitals  for  the 
sick  of  his  division,  in  this  pleasant  village.  In  pursuance  of 
orders,  the  Assistant  Qtiarter  Master  General  had  appropriated 
an  academy,  the  arsenal  and  two  pri  houses,  to  hospital  [lur- 
poses.  Within  ten  days,  these  builu.  .„s,  sufficiently  capacious 
to  accommodate  250  men,  were  made  comfortable ;  in  which 
each  patient  had  a  separate  bed.  The  wards  were  warm,  even 
during  the  utmost  severity  of  cold.  The  sick  admitted  here,  ex- 
cept such  as  were  ruite  exhausted  by  disease,  daily  improved  in 
their  health,  by  the  change  from  cold  lodgings  in  tents,  to  more 
temoerate  in  houses.  The  above  establishment  was  placed  un- 
der my  direction.  To  Captain  Dwicht,  A.  Q.  M.  General,  who 
promptly  afforded  every  assistance  in  his  province  to  bestow^ 
and  the  circumstances  of  the  country  would  alIow»  this  establish* 
ment  was  much  indebted.  l 

This  division  of  the  army  witnessed  a  series  of  Unfortunatfr 
movements  after  the  capture  of  Fort  George,  until  it  retired  into 
winter  quarters  at  French  Mills.  To  combat  the  elements,  was 
attended  with  more  losses  than  to  fight  the  enemy.  The  unsea- 
sonable expedition  of  the  army,  down  the  St.  Lawrence,  was  not 
the  final  evil  which  it  had  to  encounter. 

We  shall,  here,  give  a  retrospective  view  of  the  general  health 
of  the  army,  when  it  embarked  on  board  the  flotilla  at  Niagara* 
A  large  proportion  of  the  soldiers  were  convalescent,  and  could 
but  illy  endure  the  fatigues  and  exposures  in  open  boats,  during 
the  passage  down  Lake  Ontario,  to  Grenadier  Island.  The 
weather  was  cold,  accompanied  with  rain,  the  whole  route.  The 
flotilla  was  scattered.  The  boats  transporting  this  army  were, 
wholly,  at  the  mercy  of  the  winds  and  waves ;  and  were  not  col«. 
lected  within  a  fortnight  of  each  other,  at  the  place  of  rendez* 
Tous.  While  on  their  tedious  passage,  attended  with  great  bsor 
16 


i'i 


;'i>iii 


r.  f  '  fi 


Hill 


1; 


118 


MEDICAL  i^KETCHES. 


aril  and  serious  disasters,  many  of  the  convulescents  relapsed  in* 
to  fomter,  or  were  seized  with  new  diseases.  Some  of  the  most 
indisposed  were  transported  from  Grenadier  Island  to  Sacketfs 
liarbonr,  and  there  left  in  hospitals. 

From  Grenadier  Island,  the  flotilla,  progressing  down  the  St< 
Lawrence,  met  with  no  serious  obstructions  from  the  enemy. 
Three  hundred  boats  passed  the  batteries  at  Prescott,  opposite 
Ogdensburgh,  under  a  tremendous  fire,  with  the  loss  of  one  man 
killed  and  two  wounded.  General  Wilkinson,  from  the  time  he 
took  command  of  the  army  at  Fort  George,  until  his  embarka- 
tion, was  sick.  At  Grenadier  Island,  he  became  more  indispo- 
sed ;  and  during  his  movement  down,  was  mostly  confined  to  his 
bed.  It  hiiving  been  ascertained  that  the  enemy  with  his  dis- 
posable force  was  in  pursuit  of  the  army ;  with  a  view  to  pre- 
vent its  rear  from  being  molested,  General  Boyd  was  ordered 
with  detachments  from  his  own,  and  General  Covington's  brig- 
ades to  land  and  beat  them.  In  pursuance  to  orders,  a  landing 
was  eiTected  with  about  1200  men;  who,  in  Williamstown,  on 
the  Canada  shore  of  St.  Lawrence,  engaged  a  superior  force. 
The  field  of  battle  was  conlested  three  hours.  At  the  com- 
mencement of  the  action,  the  enemy  was  beaten ;  but  neither 
army  in  the  event  gained  any  important  advantage;  but,  in 
which,  were  displayed  by  the  officers  and  men  generally,  the 
highest  degrees  of  courage,  against  superior  discipline  and  force ; 
and  in  which  the  enemy  claimed  a  victory.  By  their  strong 
position  and  superior  management  they  frustrated  the  object  of 
this  rencounter,  when  General  Boyd  was  ordered  to  reembark 
the  army.  The  attack  was  so  severely  felt  by  the  British,  the 
retrograde  much  of  this  detachment  was  effected  without  molest- 
ation. In  the  battle  fell,  much  lamented,  General  Covington, 
a  brave  and  accomplished  officer.  The  loss  on  either  side  was 
stated  to  have  been  five  hundred  killed  and  wounded.  Those 
of  the  United  States'  troops  badly  wounded  were  left  on  the 
.  field  of  battle. 

This  action  closed  the  hostile  operations  of  the  army  against 
the  enemy  this  campaign.  It  belongs  to  officers  versed  in  high 
military  tacticks,  to  reconcile  the  plan  of  invading  an  enemy'^ 


CAMPAIGN  OP  1813. 


ni 


country,  and  entering  it  nt  its  centre  of  population,  during  an  in>- 
clement  season  of  the  year,  and  when  its  severity  was  rapidly 
progressing,  with  an  array  feeble,  destitute  of  clothing  and  pro- 
visions : — in  which,  when  possession  was  gained,  it  would  have 
to  contend  with  a  far  superior  force  at  every  point  ;  and  where 
resources  could  not  be  obtained,  except  by  way  of  Champlain ; 
nor  from  that  quarter  without  opening  a  communication  by  the 
strong  posts  of  Isle  au  Noix  and  Stone  Mill,  by  force  of  arnriB. 

Doctor  LovELL  further  observes,  that  "  during  the  whole  of 
October,  and  part  of  November,  most  of  the  troops  wete  subject- 
ed to  excessive  fatigues,  and  exposed  in  open  hoats  on  the  lake, 
when  it  rained  almost  every  day.  On  their  arrival  at  the 
French  Mills,  about  the  14th  of  November,  the  weather  became- 
intensely  cold,  and  remained  so  all  the  winter.  In  addition  to 
the  great  fatigue  to  which  the  soldiers  had  been  exposed,  espe- 
cially the  division  from  Fort  George,  most  of  them  had  lost  their 
blankets  and  extra  clothing,  on  their  march,  or  in  the  action  of*. 
11th  November,  at  Creistler's  lields,  in  Canada.  Even  the  sick 
had  no  covering  except  tents,  from  the  period  they  debarked  at 
the  Mills,  yntil  the  1st  of  January  in  the  severe  latitude  of  43 
degrees.  Provisions  were  scarce,  and  of  a  bad  quality.  Medi- 
cine and  hospital  stores  were  not  to  be  found,  having  been  lost 
or  destroyed  during  the  passage  down  the  St.  Lawrence.  Un- 
der these  circumstances  sickness  and  mortality  were  very  great. 
A  morning  report  now  before  me  gives  75  sick  out  of  a  smalt 
corps  of  160.  The  several  regiments  of  the  army,  in  their  re- 
turns, exhit)ited  a  proportional  number  unlit  for  duty.  Of  the 
75  referred  to,  39  were  reported  of  diarrhoea  and  dysentery ; 
18  of  pneumonia;  6  of  typhus,  and  12  of  paralysis  of  all  the  ex- 
tremities. Many  of  the  paralytics,  on  our  arrival  at  the  Mills, 
were  attended  with  mortification  of  the  toes  and  feet.  In  a  few 
of  these,  the  pain  was  severe ;  w'herein  opium  not  only  relieved' 
the  pain,  but  checked  tlie  progress  of  mortification.  StimulantSj 
both  internally  and  externally,  were  beneficial ;  and  when 
these  remedies  were  assisted  by  a  nutritious  diet,  warm  lodging 
and  clothing,  a  cure  was  effected.  The  last  complaint,  general* 
ly»  seized  those,  wJio,  previously  had  been  extremely  rediicpdi 


IJ 


H' 


120 


MEDICAL  SKETCHES. 


I     Ad. 


I 


;:i*^ 


by  disease  ;  and  utuler  our  unavoidablj  bad  situtatioo,  frequent-' 
]y  in  a  fev/  days  proved  fatal." 

The  statement  given  by  Doctor  Lovell  was  confirmed  by 
^spital  Surgeon  Ross,  the  senior  of  the  medical  department, 

iccomi)anied  the  army  down  the  St.  Lawrence, 
lu  the  vicinity  of  the  French  Mills,  the  cjuntry  vras  a  wilder- 
ness. Huts  and  hospitals  were  necessary,  to  render  the  army 
comfortable.  The  erection  of  these  was  a  work  of  great  labour, 
and  required  several  weeks  to  com()lete.  A  supply  of  hospital 
stores  could  not  be  obtained  nearer  than  Albany,  a  distance  of 
250  miles.  The  want  ol'  these  necessaries,  for  the  support  of  the 
very  wretched  and  enfeebled  soldier,  was  most  severely  felt.  The 
poor  subsistence,  which  the  bread  of  the  worsta^piality  afforded, 
was  almost  the  only  support  which  could  be  bad  for  nearly  seven 
"weeka. 

These  accumulated  evils  the  army  encountered  with  much 
patience  and  heroic  fortitude.  Now  it  was  tne  chief  surgeon, 
who  was  with  the  flotilla,  found  himself  loaded  with  a  weight 
of  censure ;  of  which  he  should  be  fairly  exonerated,  so  far  as  he 
was  blamed  for  the  loss  or  waste  of  medicine  and  hospital  stores 
on  the  St.  Lawrence.  It  was  abundantly  demonstrated,  that 
no  separate  transportation  for  these  stores,  although  expressly 
ordered  by  the  Commander  in  Chiefs  had  been  provided  ;  but 
that  they  had  been  improvidently  distributed  throughout' the 
boats  of  the  flotilla,  and  for  the  security  of  which  no  oflicer  had 
been,  nor  could  have  been  made  accountable. 

The  deaths,  sickness,  and  distress  at  French  Mills,  excited 
general  alarm.  The  great  mortality  had  obvious  causes  for 
its  cxistencci  In  all  such  cases,  censure  will  fall  on  some  depart- 
ment. And  as  each  was  disposed  to  exonerate  itself,  upon  which 
was  blame  more  probably  to  have  alighted,  than  the  medical — 
than  upon  the  surgeons  of  the  army,  under  whose  immediate  care 
the  victims  of  disease  were  daily  prostrated  ?  There  are  to  be 
found  some,  who,  ignorant  of  the  effects  of  medicine  on  the  hu- 
man constitution,  are  too  prone  to  believe,  its  exhibition  may 
be  equally  efficacious,  under  every  circumstance  and  condi- 
Ijoa  to  which  the  patient  may  be  subjected.     Hence  it  was  in^ 


a  is 


'jIPHWI 


CAMPAIGN  OP  1813. 


m 


correctly  inFtirreil,  when  men  vrere  beheld  expiring  under  the 
pr('8cri[)tioni  of  the  surgeons,  the  mortality  was  a  consequence 
of  injudicious  management,  or  neglect  of  duty.  Predi8|)Osition9 
to  disease,  the  effects  of  obvious  causes,  the  comfortless  condi- 
tions of  men  exposed  to  cold,  wanting  the  common  necessaries 
of  life  to  support  them,  in  their  exhausted  states,  were  seldom 
taken  into  consideration.  Doctor  LoYv.hi.^  one  of  the  must  able 
and  attentive  surgeons  of  the  army,  emphatically  observed,  '*  It 
was  imiKmsible  for  the  sick  to  be  restored,  with  nothing  to  sub* 
sist  upon  exc«pt  damaged  bread." 

At  the  time  the  division  of  General  Wilkinsow  was  delay- 
ed at  Grenadier  Island;  and  the  flotilla  put  in  motion  down  the 
St.  Lawrence,  General  Hampton's  division  penetrated  from 
lake  Champlain,  on  a  bad  road,  some  parts  of  which  almost  im- 
passable by  nature,  in  the  direction  of  Chateaugay,  to  the  bounds 
of  Canada,  where  it  met  with  some  opposition  from  the  Cana- 
dian militia  and  Indians.  After  a  feeble  effort  to  repel  the  ene- 
my, and  advance  into  the  lower  Province ;  a  retrograde  march  to 
Plattsburgh,  from  whence  the  army  had  previously  moved,  was 
ordered.  By  this  unfortunate,  imbecile  attempt  to  invade  the 
lower  Province  of  Canada  by  General  Hampton,  some  loss  was 
experienced,  and  less  honour  was  acquired.  Whether  this  appar- 
ent vacillancy  of  judgment  resulted  from  insuperable  obstacles, 
unforeseen  and  not  anticipated,  or  a  matured  determination  not 
to  co-operate  with  General  Wilkinson,  has  not  as  yet  been  de- 
veloped. 

For  the'disasters  which  attended  the  army,  and  the  non-accom- 
plishment of  the  object  of  this  movement,  General  Wilkinsow 
has  been  arraigned  before  a  court  martial,  composed  of  officers  of 
a  high  grade  and  most  respectable  standing ;  and  of  the  host  of 
charges  and  specifications  preferred  against  him,  has  been  ac- 
quitted. Success,  however,  often  makes  the  celebrated  general ; 
while  want  of  success,  in  the  public  estimation,  ensures  his  con- 
demnation. The  documents  exhibited  before  the  court,  upon 
his  trial,  are  a  full  exposition  of  all  the  important  circumstances 
relating  to  the  movement  of  his  division,  from  Fort  George,  up- 


j  i- 


; 

11" 

I. ' 

jOr  ff»  * 

1/ 

H^Ki  S ','  4 

'i 

1 

1 

'  RHII 

'  niRfJ 

in '  \ 

Wm  I 

itl^H^  1 

HlM'  M 

B^^^H»!'jnB 

^H-^ 

^^R«1^ 

1'^B  ^BT  .'■ 

1;   -: 

I'll 


U,-''. 


122 


MEDICAL  SKETCHES. 


1:}^  r 


I 


I 


mi 


i\\  the  campaign  terminated  ;  and,  when  made  public,  will  give 
stability  to  floating  public  opinion. 

The  medical  Bketchce  of  this  campaign  will  be  concluded 
with  the  substance  of  a  comtnunication  made  to  an  ofllcerofhigh 
grade,  at  the  French  Mills.        iS  '     v'^v  jl  ^     ;    *'i     •'..  . .  h'-  . 

The  greatest  evils,  to  which  the  army  has  been  sulijectetl  since 
the  war,  are  diseases  and  their  consequent  mortalily.     <^ '      "  '■ 

How  are  these  to  be  remedied  ?  is  a  question  of  the  highest 
moment.  As  causes  and  effects  are  intimately  connected,  by 
the  removal  of  the  first,  the  last  cease<  Long  ex|R)8ures  to  in- 
clement weather,  independent  of  other  causes,  are  sufficient  to 
produce  a  catalogue  of  diseases.  But  in  the  event  of  active  op- 
erations, these  causes  are  not  under  our  control.  The  unavoid- 
able casualties  to  which  an  army  at  times  may  be  subjected,  dur- 
ing cold  seasons,  may  be  partially  remedied  by  additional  cloth- 


ing. 


It  may  not  be  as  generally  known  as  it  should  be,  that,  a  large 
proportion  of  the  army  were  not,  when  lirst  enlisted,  fit  for  sol- 
diers. At  the  time  of  entering  the  service,  many  of  them  wera 
incapable  of  enduring  the  fatigues  and  hardships  incident  to  war, 
during  all  seasons  of  the  year.  Many  of  these,  habitually  intem- 
perate, with  constitutions  broken  down  by  inebriation  and  its 
consequent  diseases ;  whose  bloated  countenances  exhibited  false 
and  insidious  marks  of  health,  contribute  to  fill  our  hospitals. 
It  has  already  fallen  to  my  lot,  since  the  commencement  of  the 
war,  to  recommend  more  than  two  hundred  of  the  above  descrip- 
tion for  discharge ;  many  of  whom  had  not  been  enliikted  three 
months,  and  had  performed  only  a  few  days'  march,  during  the 
most  pleasant  season  of  the  year.  It  has  been  too  much  an  ob- 
ject with  oflicers  on  the  recruiting  service,  to  fill  up  tlteir  rolls 
with  numbers;  without  reflecting,  that  the  strength  of  an  army 
consists  in  able-bodied  men.  These  infirm  men  were  always  a 
dead  weight,  requiring  a  detachment  of  the  more  efficient,  as  nurs- 
es, or  attendhnts.  A  body  of  five  thousand  composing  our  troops, 
seldom  have  furnished  more  than  three  thousand  capable  of  ac- 
tive duty  in  the  field.  Government  has  the  means  of  remedying 
the  last  evil. 


CAMPAIGN  OP  1813. 


123 


The  health  oT  men  depends  much  on  the  officers  immediately 
commanding  companies.  Their  cleanliness  has  not  at  all  time« 
been  promptly  attended  to.  The  most  suitable  manner  of  pre- 
paring their  diet  has  been  neglected.  An  improvement  in  the 
dietetic  management  would  be  made,  should  each  corps  ami  regi- 
ment detail  a  police  officer  to  inspect  daily,  the  kitchens,  and 
enforce  upon  the  men  the  importance  of  preparing  their  rations 
in  a  manner  most  conducive  to  their  healths.  A  surgeon  may 
be  ordered  to  accompany  the  police  officer,  when  employed  oa 
this  duty  of  culinary  inspection.  A  surgeon  of  regiment  should 
not  feel  his  duty  ends  with  his  prescriptions  for  the  day ;  but  to 
obviate  disease,  as  well  as  to  cure,  is  a  part  of  his  province. 
Less  trouble  and  expense  are  required  to  employ  prophylactic 
means,  than  cure  diseases. 

The  quarters  of  soldiers  are  generally  too  much  crowded.  To 
place  1 0  or  20  men  in  a  room  1 U  feet  square,  is  very  injudicious. 
Officers  arc  not  fully  sensible  of  the  evils  \Shich  arise  from 
close  rooms,  charged  with  contaminated  air.  It  is  an  opinioQ 
too  prevalent  in  the  army,  that,  in  this  cold  season,  men  cannot 
be  made  too  warm ;  the  closer  they  are  stowed  the  better,  be- 
cause warmer,  has  been  often  alleged;  without  reflecting,  that 
UDOxygenated  air  is  more  injurious  to  healtli,  than  al)solute  qold^ 
in  pure  air.  The  evils  Which  originate  from  crowded  rooms, 
and  which  accumulate  during  the  long  nights  of  winter,  are  not 
remedied  by  breathing  a  purer  air,  during  the  active  employ* 
ments  of  the  day.  The  constitutions  of  men,  subjected  to  these 
transitions,  shew  their  morbid  eilects,  by  coughs  and  pneumatic 
fevers;  which,  when  the  causes  are  of  long  continuance,  assume 
forms  the  most  mortal,  rapid  in  their  progress,  terminating  the 
fatal  scene,  sometimes  in  the  short  space  of  24  hours.  Such 
were  the  morbid  effects  of  the  pneumonia  of  1812.  Such  have 
been  described,  at  various  periods,  under  its  most  mortal  form, 
the  spotted  fever,  by  many  physicians  of  respectability  ;  partic- 
ularly by  North  and  Gallup.  Here  the  disease,  like  a  devour- 
ing element,  quickly  dissolves  the  Cabric  of  the  constitution,  or, 
like  an  explosion  of  a  loaded  mine,  subverts  from  their  basis  the 
foundations  of  life  in  a  moment. 


\y' 


ii 


i|'  I 


■V  \ 


"I 


y'\  i 


I 


mi 


i 


124  MEDICAL  SKETCHES. 

An  ill-timed  distribution  of  clothing  it  among  the  cfinsfs  of 
disease.  It  tins  been  found,  the  woolen  garments  allowed  the 
soldiers  have  not  been  issued  until  the  warm  weather  of  summer 
commenced,  hen  winter  finds  them  either  naked,  or  cind  In 
their  summer  dresses,  perishing  with  cokl.  It  may  he  added, 
the  allowance  of  clothing  is  not  sudlcient  to  proi(>ct  the  men  on 
the  northern  frontiers  from  the  severe  frosts  of  this  inclement  cli- 
inate. 

It  cannot  be  too  frequently  Repeated,  an  intemperate  use  of 
ardent  sinrits,  is  also  among  the  destructive  evils  attached  to  our 
armies.  The  high  excitement  produced  by  ardent  spirits  is 
more  ii\jurious  to  life  in  cold,  than  hot  seasons  of  the  year  ;  a- 
pecially  if  drank  when  the  system  is  exhausted  of  its  vital  heat 
by  cold.  This  most  noxious  of  all  causes  of  disease,  to  which 
t)ur  army  is  exposed,  may  be  obviated  by  prohibiting  sutlers  to 
•ell  these  deleterious  liquors  in  the  vicinity  of  the  cantonment. 
To  elucidate  the  correctness  of  the  above  jmsitions  does  not 
require  the  aid  of  philosophic  demonstration.  It  is  only  ne- 
vessary  to  present  them  to  the  eye  of  the  understanding,  and 
they  cannot  fail  to  be  comprehended.  The  above,  however, 
fire  only  a  partial  representation  of  the  causes  of  disease  and 
death.  »  ••'     '  '  ,      . 

To  exonerate  the  medical  staff  of  the  army  from  censure,  is 
toot  my  design.  For  a  neglect  of  duty  they  may  sometimes 
«tand  chargeable.  Not  more  should  be  placed  to  their  account, 
than  is  just.  Is  a  soldier  sick  under  circumstances  already  de* 
Bcribed,  and  does  he  die  under  the  hands  of  his  surgeon  ?  his 
death  is  too  often  imputed,  either  to  his  ignorance  or  inatten- 
tion, by  officers  who  are  no  less,  perhaps  moie  greatly  deserving 
of  blame.  L  is  a  disingenuous  fact,  the  surgeons  of  the  army 
fire  made  mere  scape'-goats,  on  whom  are  heaped  a  multitude  of 
sins ;  which,  without  a  figure  of  speech,  art;  imputable  to  causes* 
over  which  they  have  no  control.  ' 

END  OF  CAMPAIGN  iai3* 


w^ 


T  i  -V  Vifi    lA  Mil.iW 


f^K* 


.  1 .  •  »• 


f-  •! 


•„  .   >.   ■      .,Ml|r»  wi    (.'li  .  , '•      til    .    \-ji'>A'..-    '   ,/    ' 

CAMPAIGN  OF  1814. 


I  ,.> 


wwwvwwvvw^wv 


At  M alone  HoBpital,  on  the  1st  of  February,  1814,  the 
miraher  of  sick  had  increased  to  450.  For  an  additional  number 
of  200  sent  from  French  Mills,  rooms  were  wanted ;  which  were 
promptly  provided  by  Captain  Dwioht,  A.  Q.  M.  General; 
who  continued  to  give  me  his  assistance. 

In  addition  to  diseases  already  enumerated  the  preceding  can> 
paign,  (among  which,  diarrhoeas  were  the  most  prevalent,)  was 
the  pneumonia  of  1812-13.  The  disease  was  accompanied  with 
all  the  same  symptoms  under  which  it  appeared  the  preceding 
winter ;  but,  its  attacks  were  less  frequent.  There  were  two  ca- 
ses where  the  patient  did  not  survive  12  hours  after  the  first  io^ 
disposition  supervened.  There  were  a  few  cases  of  disease 
which  assumed  the  form  of  spotted  fever — in  which  the  brain 
seemed  to  be  the  seat  of  disease;  a  mental  derangement  having 
been  the  first  alarming  symptom,  without  any  pneumonic  afTec^' 
tion.  The  progress  of  the  symptoms  was  so  rapid,  that  no  deci> 
eive  mode  of  practice  was  adopted.  All  of  these  died  within 
the  first  24  hours.  Two  of  the  number,  within  six  hours.  A 
nurse  in  the  hospital,  apparently  in  good  health  in  the  morning 
at  9  oViock,  became  deranged ;  soon  after  comatose,  at  3  P.  M. 
was  a  corpse.  Many  of  the  sick  had  swelled  feet  and  legs ; 
some  of  these  were  accompanied  with  mortifications;  the  conse- 
quence of  long  confinement  and  inactivity  in  the  boats,  wet  an4 
cold,  during  the  passage  of  the  army  down  Lake  Ontario  and 
the  river  St.  Lawrence. 

Six  or  seven  weeks  elapsed  before  the  men  were  made  cortir 
fortable  in  their  barracks,  at  the  Mills.  .  By  this  time,  provisions 
had  arrived  fVom  Plattsburgh  and  Utica,  of  a  better  quality  than 
17 


I 


I    h 


:  ;|||:  Hi 

it              ■        <      ■ 

'< 


\» 


MEDICAL  SKETCHES. 


if|i 


} 


bad  previously  been  iuued.  Am[ile  luppUes  of  hospital  storei 
\vere  received  from  Albany,  uuder  the  charge  of  Doctor  Low, 
AMiitant  to  the  Apothecary  General.  The  men  daily  improv- 
ed in  tlieir  appearance ;  time  was  had  to  clean  themselves;  while 
order  and  discipline  assumed  the  place  of  afiparent  confusioa 
imd  bustle,  which,  during  the  building  of  huts,  seemed  to  exist. 

This  relaxation  from  severe  toils  and  labour  was  l)ut  momen- 
tary. About  the  0th  of  February,  an  order  was  issued  to  leave 
this  cantonment.  One  division,  under  the  command  of  General 
BiiuwN,  moved  up  tlie  Bt.  Lawrence  to  Sackett's  Harbour ;  the 
other,  under  the  immediate  command  of  the  Commander  in  Chier, 
directed  its  march  to  Plattsburgh. 

In  consequence  of  this  retrograde  movement  of  the  army  from 
French  Mills,  the  hospital,  at  Malone,  at  this  time,  under  good 
fegulatione  was  broken  up,  and  the  sick  were  ordered  to  proceed 
on  routco  destined  for  their  "eapective  regiments.  Those  for 
Plattsburgh  and  Burlington  were  accompanied  by  myself.  It 
was  no  inconsiderable  task  to  transport  450  sick  men,  or  more, 
at  this  season  of  the  year,  through  a  country  almost  destitute  of 
inhabitants,  a  distance  of  70  miles.  Some  of  whom  were  ex- 
tremely reduced  with  fevers  and  diarrhoeas.  Others  were  conva- 
lescent. The  few  accommodations  on  this  route  were  wretch* 
ed.  The  inhabitants,  although  kind,  were  not  under  circum- 
stances to  furnish  means  to  render  the  situation  of  sick  men  ev- 
en comfortable.  Nothing  was  omitted  within  their  abilities,  to 
meliorate  their  miserable  condition. 

Knowing  that  so  large  a  detachment  of  sick  and  invalids 
could  not  be  cov(  red  at  night,  if  they  moved  in  a  body ;  the 
sleigliS  which  transported  them  were  successively  put  in  mo- 
tion, in  small  divisions.  Their  line  of  movement,  three  days 
forming,  extended  the  whole  distance  from  Malone.  The  first 
division  arrived  ^t  Plattsburgh,  the  place  of  their  destination, 
aliout  the  time  the  lust  commenced  its  progress.  About  20  very 
sick,  who  were  left  in  the  hospitals,  under  the  care  of  a  citizen 
physician,  were  made  prisoners  of  war  by  the  British ;  who  im- 
mediately followed  the  retrograde  march  of  the  army,  as  far  as 
Ualoue.     Those  left  in  the  hospitals  were  not  molested  in  their 


mtmr 


CAMFAtON  OP  1814, 


m 


^non»,  but  were  only  obliged  to  sign  their  parolei.  The  greal^ 
tr  part  of  whom,  nfter  five  and  aiiL  weeki,  joined  the  hospital  at 
BiirliiiRton.  During  thia  movement  of  the  aicic,  aix  died,  while 
ninny  improved  in  their  healtha ;  notwilhalauding  it  anowed  or 
rained  during  the  whole  journey.    ^.    •,  f^<i    t  •'  „^  ><^^ 

U|K)n  the  10th  of  February,  !■  arrived  at  Burlington  ;  where 
about  hnlf  of  this  detachment  of  aick  had  arrived.  There  werev 
then  in  the  hospital  here,  about  ItiO  of  General  Hampton's  dU 
vision. 

After  preparntiona  were  made  Tor  our  increasing  number,  foi 
whose  accommodation,  in  addition  to  tJie  hospital  house,  20 
rooms  of  the  common  barracks  were  provided,  the  wards  wera 
inB|iected,nnd  the  men  classed  and  distributed  according  to  their 
diseases  and  conditions. 

The  epidemic  of  1812-18  was  among  the  prominent  diseasea 
also,  in  tliia  hospital.  Although  it  was  not  so  generally  preva* 
lent  as  the  preceding  winter,  there  were  some  strongly  marked 
cases,  sudden  in  their  onset,  with  suffocated  respiration,  con- 
tracted pulse,  cold  extremities,  and  a  heavy  dull  pain  in  the 
chest. 

My  attention  was  called  to  one  case,  of "  ^ew  hours  duration. 
After  directing  heated  woolen  clothes  to  his  extremities,  bleed- 
ing  was  directed ;  when  it  was  understood,  there  had  been  some 
disagreement  between  four  or  five  young  gentlemen  attached  to 
the  hospital,  respecting  the  proper  method  of  treatment.  All  oi' 
whom,  excepting  one,  objected  to  bleeding ;  having  never  wit- 
Dessed  its  employment  under  similar  states  of  disease;  and  con- 
sequently were  strangers  to  its  beneficial  effects.  The  quantity- 
first  taken  away  was  eight  ounces.  About  one  hour  after  the 
operation,  I  visited  the  man,  and  found  him  relieved,  as  to  the 
laborious  respiration.  In  the  evening  of  the  same  day,  difficult 
respiration  had  returned  with  increased  heat  and  fuller  pulse  ; 
when  eight  ounces  were  again  taken  away.  The  day  following, 
he  was  bled  eight  ounces  the  third  time^  After  which,  he  con- 
valesced, and  in  three  days  was  able  to  walk  his  viard,  having  a 
returning  appetite. 

The  foJUowiog  days,  five  or  six  similar  caseB  were  treated  ia 


I* 


T 


^•mm 


t 


m 


128 


iMKDICAL  SKETCHES. 


;(;   :-i 


like  mftitner,  under  my  imraedinte  direction ;  who  allM  recover- 
ei\.  After  these  successful  exhibitions  of  bteedinj^  in  these 
pneumonic  diseaees,  no  further  opposilion  was  mnde  to  the  use  of 
the  lan«et  in  hospital  practice,  in  similar  forms  of  disease.  I  do 
not  hesitate  to  say,  that  more  than  one  hundred  were  saved  by 
this  oj)eration.  We  had  this  disease  completely  under  our  con- 
trol, if  seasonable  application  was  made.  The  auxiliary  reme- 
dies were  a  cath.  of  jalap  and  calomel ;  calomel  and  opium  in 
small  doses ;  autimonial  wine  and  camphorated  tine,  of  opium, 
as  expectorants ;  and  blisters  upon  the  chest.  Small  emetics, 
after  bleeding  and  evacuations  by  the  bowels,  were  occasionally 
employed.  The  epidemic  of  this  winter,  as  heretofore,  fell  up- 
on those  with  the  greatest  force,  who  were  either  advanced  in 
years,  or  intemperate.  '    '     "^  '^"'  ».rr  •,,  . 

Intermittents  shewed  themselves,  in  a  few  instances,  dpring 
the  months  of  Febru  .ry  and  March,  1814.  Some  of  these  cases 
•were  admmitted  patients,  who  had  been  treated  by  regimental 
Surgeons  in  quarters  ;  wherein  the  disease  appeared  obstinate — > 
not  yielding  to  remedies  commonly  employed.  Previous  to 
their  admittance,  emetics  and  cathartics  had  been  administered ; 
after  which,  the  bark,  aromatics,  bitters  and  wiue  in  large  quan- 
tity without  any  benefit.  Their  treatment  in  the  hospital  was 
commenced  with  Fowler's  mineral  solution ;  not  with  those  good 
effects,  however,  which  had  been  experienced  from  its  employ- 
ment, on  former  occasions,  at  Lewistown,  on  the  Niagara.  This 
unsuccessful  practice,  by  the  most  usual  mean?,  persuaded  me 
that  these  intermittents  partook  of  the  type  of  the  prevailing 
pneumonia.  Sydenham  and  Rush  have  observed,  that  during 
epidemics,  all  complaints  assume  tire  nature  of  the  prevailing 
disease.  Recourse  was  next  had  to  remedies  employwl  in  the 
epidemic  pneumonia;  as  bleeding,  calomel  in  small  doses,  and 
antimonials.  This  practice  was  more  especially  adopted,  inas- 
wiuch  as  these  intermittent  fevers  were  accompanied  with  some 
»Uo;bt  affections  of  the  lungs. 

The  patients  with  these  intermittents  were  bled  from  12  to  16 
•onces  during  the  exacerbation  of  the  febr'le  stage.  Then  jalap 
gr.  X.  calomel  gr.  x.  were  administered  for  a  cathartic  j  or  sijJ- 


CAMPAIGN  OF  1814. 


129 


phate  or  soda ;  or  ol.  ricini.  From  one  to  two  grains  of  calomel 
were  administered  every  six  or  eight  hours,  and  interme<Iietely 
8  tea-»])Oonful  of  nntimonial  wine.  The  paroxism  seldom  re- 
turned after  bleeding  and  the  operation  of  a  cathartic.  Bark 
and  wine  were  of  no^use,  until  t^e  excitement  was  equalized 
throughout  the  system,  and  became  permanent,  and  the  local 
affection  of  the  lungs  entirely  removed. 

Epilepsy  was  among  the  diseases  with  which  we  had  to  con- 
tend in  the  hospital  at  Burlington ;  and  over  which  we  made 
ourselves  completely  triumphant  by  the  employment  of  nitrate 
«f  silver.  By  this  medicine  alone,  the  morbid  action,  which 
eonstituted  the  disease,  vas  entirely  subdued. 

The  following  eases  mere  taken  from  the  prescription  books  of 
the  Hospital,  and  will  be  here  insertedy  in  the  form  as  there- 
in appeared. 

CASE   FIRST. 

George  Watkins,  10th  regiment,  admitted  5th  March,  1814. 
The  preceding  month,  this  patient  had  been  daily  attacked  with 
fits  four  or  five  times.    His  treatment  was  not  known,  when  with 
his  regiment. 
March  6th.  Rs.  Calomel  gr.  x.  pro  cath. 

7fh.  The  fits  continuing  as  he/etofore.  Venoesectio  ^  xvi. 
8th.  The  disease  continues.  Emplas.  epispastic.  pro  capite. 
9th.  The  fits  continue. 
10th.  Rs.  Nitras  argent,  gr.  J.  fiatpilj.    Sexta  quaque  bo- 

•     ra  capiat. 
12th.  No  fit  yesterday.     Nitras  pill.  cont.  ut.  supra. 
13th.  No  fits.     Nitras  pill.  cont.  ute  supra. 
14th.  The  nitrate  pill  discontinued,  in  consequence  of  a 
sore  mouth,  and  small  discharges  of  blood  with  the 
fcecal  evacuations,  and  gripes. 
15th.  Rs.  Nitras  pill,  bis  in  die,  cum  laud.  liquid,   gt.  xx. 

capiat  asger. 
16th,  17th,  18th,  19th.   The  last  medicines  were  continu- 
ed.   Since  which  there  was  no  return  of  fitst 
May  Ut.  Reported  for  duty. 


'  ii 


030 


SffiDICAL  SKETCHES. 


--l 


■>».-    lA-.:^*^ 


.,.^'..  .   :.   ..  ... _^.       <         CASE    SECONO.       ■■'    !--  -i-    •   • 

Oliver  Spekcer,  29th  regiment,  had  been  subjected  to  epi* 
lepsy  seven  months.  During  which  period,  he  had  been  treated 
in  the  hospital  by  a  routine  of  evacuants,  antispasmodics,  tonics 
and  blisters,  without  any  benefit.  The  following  was  his  treat- 
ment. ,,,,    ..;■■>     /<j.-rt,,H,..,:-,  » 

February  28th.  Rs.  Calomel  gr.  x.  RhoBi.  gr.  x.  pro  caihart 

March  1st.  Rs.  Laud.  liquid  ^  i.  Sp.  Nit.  dulds  ^  i.  capiant. 
gult  X.  quaque  hora. 

The  above  was  continued  until  March  1 6th;  during  which 
period  the  fits  recurred  from  ten  to  twenty  times  in  a  day. 

March  16th.  Rs.  Nitras  argent  gr.  ^.  fiat  pill,  quaque  sexta 
hora  capiat  a!ger. 

After  the  first  dose  was  administered,  there  was  no  return  of 
fits. 

17th  to  20th.  The  above  medicine  was  continued;  after 
which  date,  the  nitrate  was  discontinued ;  and  believing  the  dis- 
ease to  be  overcome,  medicine  was  deemed  unnecessary. 

Three  similar  cases  were  also  treated  in  a  similar  manner 
with  the  nitrate  pill,  and  with  like  good  effects.  In  every  in- 
stance,  the  fits  did  not  recur,  after  the  administration  of  the  first 
dose.  The  nitrate  of  silver  was  made  into  a  pill  with  crumbs  of 
bread,  and  solution  of  gum  arable. 

The  result  of  the  above  cases  is  evidence  the  nitras  argenti 
is  a  valuable  medicine  in  this  form  of  disease.  The  present 
communication  might  be  more  valuable,  if  it  were  possible  to 
slate  all  the  circumstances  which  preceded,  or  accompanied  the 
first  attacks  of  the  complaint. 

A  history  of  the  causes  which  induce  a  predisposition,  or  those 
which  more  immediately  excite  a  morbid  action  in  the  system, 
might,  in  many  instances,  direct  to  the  most  appropriate  remedy. 


Dropsies  were  very  frequent  in  the  hospital  at  Burlington, 
particularly  among  those  soldiers  who  belonged  to  the  division 
from  Fort  George.     It  is  worthy  of  observation,  tliat  djropsies 


CAMPAIGN  OF  nU. 


in 


frequently  occurred,  where  chronic  diarrhoea  was  suddenly  check> 
ed.  These  dropsical  swellings  appeared  under  forms  of  general 
anasarca,  or  ascites,  or  both  combined.        ■'»  '••**     a'  *'rj*  ..i..* 

Previous  to  taking  direction  of  the  hospital  at  Burlington,  in 
February,  1814,  acetite  of  lead  had  become  a  con^mon  pre8crip« 
tion,  in  the  hospital  practice,  in  cases  of  chronic  diarrhoea.  Prej- 
udices  against  the  internal  use  of  acetite  of  lead,  from  education, 
I  had  always  possessed.  To  Ihe  indiscriminate  employment  of 
this  medicine,  in  the  above  disease,  strong  objections  were  op- 
posed. Soon  after  taking  charge  of  this  hosjiital  there  were  no- 
ticed, when  visiting  the  wards,  an  astonishing  number  among  six 
hundred  patients,  some  of  whom  young  men  afflicted  with  drop^ 
sical  swellings.  The  circumstance  led  me  to  enquire,  the  condi- 
tions of  these  patients,  when  admitted  into  the  hospital.  It  was 
made  known,  they  all  had  diarrliocas ;  and  as  soon  as  the  diar- 
rhoeas were  stopped,  the  body  and  lower  extremities  became 
bloated,  oedematous  and  dropsical.  It  was  also  ascertainedj  that 
these  diarrhoeas  had  been  checked,  while  under  the  use  of  acetite 
of  lead.  There  was  no  hesitation  in  my  mind  to  believe,  these 
dropsies  were  a  consequence  of  the  sudden  check  of  dischargeir 
from  the  bowels,  caused  by  tlie  injudicious  administration  of  this 
poisonous  drug.  ■■    .  < 

The  acetite  of  lead  has  been  intro<luced  into  practice,  as  a 
lafe  and  valuable  medicine,  in  dysentery  and  diarrlioea,  by  some 
very  respectable  physicians.  It  will  eiTect  a  cure  of  these  d^ 
eases  without  ill  consequences,  when  managed  with  prudence* 
Notwithstanding  the  high  reputation  of  this  medicine,  its  long  ad*- 
ministration,  in  any  case,  renders  it  dangerous.  The  obstinate 
diarrhoeas  in  the  army  often  required  its  long  use ;  hence  the  iiN 
jurious  consequences  which  followed. 

The  formidable  dropsical  swellings  were  removed  by  drnstie 
purges.  The  digitalis  purpurea  was  resorted  te,  as  a  remedy  ia 
obstinate  cases.  These  complaints  were,  sometimes,  accompanb 
ed  with  an  enlargement  of  the  liver,  and  obstructions  in  the  ductua 
communis  choiedocus ;  as  jaundice  associated  itself  with  the  oth^ 
er  symptoms.  When  the  last  states  were  evident,  calomel  was 
directed,  in  imall  doses ;  also  mercurial  embrocations,  on  the  ce- 


.1      !•' 


-  '< 


i'illii 


13? 


MEDICAL  SKETCHES. 


■|  (■ 


gion  of  that  viscus  were  in  some  instanceb  employed  with  >)UCceMk 
8ome  few,  however,  resisted  every  mean  employed.  That  these 
ilropsies  were  the  consequence  of  the  sudden  check  of  diarrhoeas 
by  acetite  of  lead,  was  most  evident ;  for,  as  soon  as  the  diar- 
rhoeas returned  by  the  employment  of  cathartics,  the  swellingt 
subsided.  It  was  observed  also,  there  was  a  strong  constipation 
uf  the  bowels,  especially  a  rigid  contraction  of  the  sphincter  ani ; 
which  was  not  overcome,  except  by  frequent  repetition  of  ca> 
thartics.  Whenever  a  diarrhoea  was  induced  by  medicine,  these 
flropsical  swellings  rapidly  disappeared.  ;«i.  *  :~>.  <  *:vr-'-^.  :v>n(^| 
The  deleterious  effects  of  acetite  of  lead  were  most  evident, 
in  two  cases,  circumstantially  reported  by  Doctor  Henry  Hunt» 
liospital  surgeon  in  the  army.  His  communication  has  been, 
already,  published  in  the  Medical  Re|)ository,  at  New  York. 
To  one  of  these  I  was  called,  occasionally,  in  consultation.  It 
is  here  inserted,  in  connection  with  other  injurious  effects  of  thb 
potent  medicine. 

*'  General  Hospital,  Burlington,  Vt.  Sept.  15,  1814. 

"  The  following  is  a  statement  which  was  given  me,  [writes 
Doctor  Hunt,^  by  Major  Bcbeb,  one  of  the  sufferers,  at  my  first 
interview  with  him,  which  was  several  mouths  after  the  com- 
mencement of  the  disease.  .    ^       .  fV,  ,*.:4   &.si 

*'  About  the  middle  of  November  last.  Colonel  Johnson  and 
myself  were  attacked  with  diarrhoea,  and  consulted  at  Malone  a 
surgeon,  (then  belonging  to  the  army,)  who  g^ve  us  a  box  of  as- 
tringent pills  about  the  size  of  large  peas  (afterwards  discovered 
to  be  the  acetite  of  lead)  with  directions  to  take  ihem  frequently, 
until  our  disease  was  checked.  On  an  average  we  took  five  or 
six  a  day.  Much  relief  was  procured  by  them,  and  by  the  last 
of  the  month  we  returned  to  duty  at  French  Mills,  apparently 
cured.  We  were  so  much  pleased  with  these  pills,  that  each  of 
us  took  a  large  box  on  our  departure,  and  frequently  afterwards 
had  recourse  to  them,  whenever  our  disease  shewed  a  disposition 
to  return. 

*'  On  the  5th  of  December,  Colonel  Johnson  was  attacked 
with  a  violent  pain  in  his  stomach  and  bowels,  attended  with  » 


OAMPAION  OP  1814.' 


133 


l! 


firequent  diflposition  to  puke,  and  a  powerrul  tenesnus.  Medical 
aid  was  immediately  procured,  and  the  most  prompt  and  active 
remedies  were  applied  without  relief.  The  symptoms  daily  in> 
creased  in  violence,  and  he  lingered  seven  days,  tortured  with 
excruciating  pain,  and  retained  his  senses  until  he  died. 

'*  After  the  death  of  my  friend  (not  knowing  the  cause  of  his 
death,  or  the  composition  of  the  pills)  I  frequently  resorted  to 
my  box.  Early  in  January,  being  much  exposed  to  cold  and 
wet  weather,  I  was  suddenly  seized  with  a  pain  in  my  side, 
which  was  supposed  to  be  the  pleurisy :  for  thb  I  was  bled  and 
blistered  with  considerable  relief.  Soon  afterwards  I  waa  taken 
with  sickness  at  my  stomach,  attended  with  flatulences,  and  a 
violent  pain  in  my  bowels,  with  tenesmus.  A  copious  discharge 
of  sweet  saliva  soon  followed  this  attack,  and  continued  some 
time.  During  this  month  I  suffered  great  pain  in  my  stomach 
and  bowels,  likewise  in  all  my  joints,  and  bunches  of  knots  arose 
over  my  abdomen.  My  bowels  were  costive,  and  my  appetite 
entirely  destroyed.  For  these  I  took  pills  of  calomel  until  my 
mouth  was  sore,  and  a  latge  dose  of  sulphur  was  given  daily  ; 
the  operation  of  which  never  failed  to  increase  the  pain  in  my 
bowels.  Injections  were  used  with  some  palliation ;  but  the 
sphincter  ani  soon  became  so  contracted,  that  the  pipe  was  witk 
pain  and  difficulty  introduced. 

"  About  the  middle  of  February  I  left  French  Mills,  and  a6- 
rived  at  this  place  (Burlington)  the  20th,  in  great  pain.  I  waa 
again  salivated  without  relief,  and  afterwards  took  Dover's  ik>w« 
(lers  during  the  month  of  March.  My  disease  continued  to  grow 
more  violent  and  alarming,  with  pain  and  numbness  in  my  ev 
tremities,  and  an  abscess  on  each  of  my  legs.   •  ;    '-  *■■*>  v  «,• 

*'  In  April  I  took  wine  and  bark,  but  had  no  appetite  to  eat. 
The  symptoms  all  continued,  and  I  could  not  sleep,  without  the 
aid  of  large  quantities  of  opium."  - 

Doctor  Hunt,  in  continuance  of  his  communication,  says,  "  I 
was  cali.^d  on  to  visit  the  Major  about  the  middle  of  May.     He 
was  lyirrT  in  bed,  and  looked  pale  and  emaciated,  his  eyes  were 
sunk,  his  cheeks  hollow,  and  his  countenance  directed. 
18 


fi'; 


it -I 


J 


f  .' 


134 


MEDICAL  SKETCHES. 


I 

i  { 
\ 


i|. 


;  Wi 


*'  He  told  me  he  vfas  in  violent  pain,  which  could  not  be  pal« 
liated  without  taking  two  or  three  grains  of  opium  every  three  or 
four  hours.  His  bowels  were  obstinately  costive,  and  he  was 
obliged  to  take  some  purgative  medicine  every  day  ;  the  opera- 
tion of  which  was  severely  painful,  (the  sphincter  ani  being  still 
much  contracted.)  Food  was  loathsome  to  bim,and  he  had  pro- 
fuse perspirations,  for  which  he  was  taking  wine  and  bark.  A 
deep  seated  abscess  was  formed  on  one  leg,  and  a  superficial  ulcer 
on  the  other.  The  gastrocnemii  muscles  were  enlarged  and  in- 
durated, and  bia  arms  partially  paralizeik   y,  r  •■,..,;:  -  , 

I  soon  discovered  that  the  wine  and  biark  aiggravated  his  dis- 
ease, and  substituted  milder  tonics,  until  I  had  tried  the  whole 
list  of  metalic  and  vegetable  tonics,  without  auy  good  effect ;  when 
I  was  obliged  to  abandon  th«>ni  altogether,  although  his  feeble 
pulse,  cold  skin,  and  great  debility  fully  justified  the  practice. 

*'  I  endeavored  to  restore  his  appetite,  by  lessening  the  quan- 
tity of  opium,  and  substituting  the  tine,  of  hops,  as  much  as  pos- 
sible. Sweet  oil  was  given  every  day,  for  the  constipation  of  bis 
bowels,  large  blisters  were  applied  over  the  abdomen,  for  the 
pain  'y-  and  his  arms  were  freely  blistered  for  the  paralysis.  His 
legs  w«re  washed  with  a  decoction  of  galls  twice  a  day,  and 
lightly  dressed,  (the  irritation  being  so  great,  that  the  slightest 
touch  was  painful  to  him)  His  appetite  was  frequently  coaxed 
by  some  delicacy,  and  the  sweet  oil  was  frequently  alternated  by 
magnesia  and  rhubarb.  ...  ^i.-^^,.. 

"  This  treatment  was  regularly  puhiited  until  the  last  of  June ; 
and  although  he  suffered  much  pain  during  that  time,  he  was 
evidently  much  better,  and  his  appetite  improved.  He  slept 
much  better  at  night,  and  took  but  little  opium;  lie  had  no  pro- 
fuse perspirations ;  the  sphincter  ani  was  more  relaxed,  and  his 
legs  were  nearly  ciu^ed.  The  pain  in  his  bowels  was  less  fre- 
quent, and  not  so  violent.  He  was  cheerful,  and  talked  of  soon 
returuiiig  to  his  duty,      it-.- »J«t   v.  rA.'i,-.'i!f!»t,^..  tvi  tjiuA    rt^-v,!'! 

"  July  4th.  I  was  sent  for  in  great  haste  to  visit  him.  When 
I  entered  his  room,  I  was  astonisheil  at  his  altered  appearaace. 
His  countenance  was  pale  and  fallen;  he  was  silting  up  in  hit 
bed,  struggling  for  breath ;  his  body  was  covered  with  cold  and 


IPMJIIJJIll      I      I 


CAMPAIGN  OP  1814. 


U5 


clammy  sweats ;  and  he  had  a  most  anxious  and  dcspondini; 
look.  In  a  few  words  he  informed  me  that  he  was  suddenly 
seized  with  a  violent  pain  in  his  stomach  and  brenet ;  that  he 
could  not  breathe,  and  must  die  in  a  few  moments.  I  immedl- 
ntely  gave  him  large  quantities  of  telher  and  laudanum ;  applied 
flannel  dipped  in  hot  spirits  to  his  stomach  and  breast,  and  or- 
dered anodine  injections  to  be  frequently  and  copiously  used, 
until  the  paiu  subsided,  this  treatment  gradually  relieved  him 
during  the  day  ;  at  night  a  large  blister  was  applied  over  the 
stomach  and  breast,  and  the  aether  and  laudanum  continued. 

"  The  injections  brought  away  from  his  bowels  large  quanti- 
ties of  dark  and  hardened  feeces.  They  were  repeated  every 
day  during  this  month,  with  the  happiest  effect ;  and  it  was  as- 
tonishing what  masses  of  these  dark  and  indurated  faeces  were 
evacuated  during  this  time. 

"  About  the  latter  end  of  this  month  he  complained  of  great 
difficulty  in  voiding  his  urine,  and  was  always  obliged  to  make 
strong  efforts  for  several  minutes  before  he  could  accomplish  his 
wishes  ;  when  the  urine  would  suddenly  start  in  a  full  and  co- 
pious  stream.        .•■■—■■■■  .-- ■  - 

"  August — In  the  commencement  of  this  month,  his  thorax 
and  abdomen  were  entirely  relieved  from  all  uneasiness,  and  he 
was  again  flattering  himself,  that  his  disease  was  subdued ;  when 
he  was  suddenly  seized  with  a  violent  pain  in  his  left  hand  and 
arm,  attended  with  an  emphysematous  swelling.  This  continu* 
ed'  until  the  middle  of  the  month,  without  the  least  abatement, 
when  a  similar  affection  commenced  in  the  right  knee ;  and  in 
proportion  to  the  increase  of  pain  and  swelling  in  this  part,  those 
of  the  hand  and  arm  diminished.  He  was  tortured  Avith  the  most 
agonizing  pain  the  rest  of  the  month,  which  nothing  but  large 
quantities  of  opium  could  lull  for  a  moment.  Repeated  blisters 
and  other  applications  were  used  without  any  relief.    ' ' 

"  September  1st.  Is  much  emaciated  and  exhausted  by  want 
of  sleep.  His  left  foot  and  knee  are  also  affected  with  great  pain 
and  swelling.  >         -   .'.  ■         •• 

"  6th.  The  pain  and  swelling  have  pervaded  all  his  extrem- 
ities. Opium  can  no  longer  lull  his  pain,  and  nothing  but  death 
now  seems  to  oflfer  him  any  hope  of  relief. 


1 1 


>i> 


i 


k 


'4 


IH 


h  * 


m 


\\\ 


136 


MEDICAL  SKETCHES. 


**  8lh.    Rii  extremitiei  are  completely  paralized.  ^  «^^ 

*'  loth.  Ii  affected  vtMh  erysipelas,  and  is  (gradually  sinking 
Into  a  state  of  insensibility.  In  this  state  he  lingered  until  the 
13lh,  when  he  expired  nvithout  a  struggle.  >  •»*M 

.  I;.  ,   v;V»;^».»./*»  iMrrhj-lJ  "  HENRY  HUNT,     ,,^, 

"  Hospital  Surgeon  U,  S.  Army. 


I.I 


'•«'#>«(  I  V*.  >t<r>««'f*- 


*'  P.  S.  In  addition  to  the  above  cases,  I  have  seen  several 
others  produced  by  the  same  cause,  since  I  have  been  on  this 
Trontier.  Chronic  diarrhoea  is  a  common  complaint  on  the  bord- 
ers of  Lake  Champlain,  and  the  sugar  of  lead  was,  at  one  time, 
a  fashionable  remedy  among  the  surgeons  of  the  army.  It  was 
often  given  to  the  men,  while  in  the  tented  field,  and  exposed  to 
all  the  varieties  of  this  fickle  climate.  Without  being  caution- 
ed, and,  ignorant  of  its  baneful  effects,  no  doubt  some  of  them 
used  it  improperly.       ,    »„,.,    ..,,  >,.   ..,„    ....*♦.„«.,  ««.4,*  ., 

"  No  one  appreciates  more  highly  than  I  do,  this  valuable  ar- 
ticle of  the  materia  medica ;  but  great  caution  ought  to  be  ob- 
served in  its  administration,  without  which  much  is  to  be  fear- 
ed, that  it  will  oftener  prove  a  hane,  than  an  antidote  to  man ; 
especially,  as  some  physicians  express  doubts  of  its  deleteriouv 
efifects."  ,,       ,  ,  .  H.  H.  &c. 

«April20th,  1315."  ,  , 

The  above  effects  of  acetite  of  lead,  at  Burlington  hospital, 
brought  to  mind  two  cases  of  colica  pictonum,  which  occurred 
at  Lewistown,  on  the  Niagara,  the  preceding  summer,  when  di- 
arrhoea was  the  prevailing  epidemic,  and  sugar  of  lead  was  by 
some  employed  as  a  remedy.  One  of  these  expired  on  the 
ivA  day  after  the  attack.  The  other,  by  the  use  of  cath.'^rtics ; 
calomel  in  large  doses ;  olium  ricini ;  injections  frequently  re- 
peated, and  warm  baths,  recovered.  Having  no  suspicion  at  the 
time,  that  these  attacks  might  have  been  occasioned  by  the  pre- 
vious employment  of  medicine,  no  enquiries  were  made,  what 
their  states  had  been  previous  to  their  seizure.  It  was,  however, 
conjectured  at  the  time  by  myself,  that  these  complaints  might 
have  been  produced  by  adulterated  wine,  which  was  sold  at  the 


M! 


CAMPAIGN  OP  1814. 


137 


ttorei  and  by  sutlers  oT  the  armj ;  as  it  is  well  known,  that  wine- 
sellers  Trequently  sweeten  their  low  and  sour  wines,  by  acetite  of 

The  case  of  Major  Beebe  requires  a  more  full  exposition. 
When  he  first  arrived  at  Burlington,  in  February,  he  was  at- 
tended by  myself.  At  that  time  he  was  not  extremely  reduced. 
A  journey  of  ninety  miles,  added  to  the  stimulants  with  which 
he  had  indulged  himself,  to  resist  the  inclemency  of  the  weather 
during  the  route,  had  induced  a  high  degree  of  arterial  action, 
and  considerable  increase  of  heat  There  was  a  small  abscess 
on  one  leg,  and  a  large  intumescence  on  the  other,  in  an  incipi- 
ent state.  To  reduce  the  sthenic  diathesis,  which  evidently  ex- 
isted, blood-letting  and  a  cathartic  were  prescribed.  The  relief 
procured  by  these  was  small  and  temporary.  After  administer- 
ing some  small  doses  of  antimonials,  it  was  agreed,  in  consulta- 
tion with  two  physicians  of  the  army,  to  put  him  upon  small 
doses  of  calomel,  until  his  mouth  became  sore.  Thin  was  again 
advised,  as  he  had  found  some  benefit  by  this  process,  when 
first  employed  at  Constable,  near  French  Mills.  His  greatest 
painful  suffering  seemed  to  arise  from  the  forming  abscess ;  upon 
which  emolient  poultices  were  appUied  several  days.  These  had 
little  or  no  effect  to  bring  it  to  a  state  of  maturation ;  when  a 
blister  over  the  swelling  was  directed  with  no  better  success ; 
after  which  was  applied  a  stimulating  plaster  of  the  gums.  The 
pain  increased  with  the  enlargement  of  the  swelling,  until  a 
deep  seated  fluctuation  was  distinctly  perceived  under  the  gas- 
trocnemius muscle.  It  is  to  be  noticed,  that  even  now  the  su- 
perincumbent teguments  were  not  inflamed,  the  skin  not  in  the 
least  discoloured.  An  opening  was  made  into  the  encysted  mat- 
ter, which  was  sanious  instead  of  being  purulent,  as  was  expect-^ 
ed.  No  relief  was  procured  by  this  operation,  but  the  swelling 
continued  extremely  painful.  The  sore  was  dressed  with  a  sim> 
pie  pledgit  of  cerate. 

After  the  calomel  was  employed  to  an  extent  which  had  been 
proposed,  and  no  relief  procured  by  all  the  means  employed,  he 
was  advised  to  warm  baths,  to  remove  general  wandering  pains. 
These  not  giving  relief  proportionate  to  the  trouble  of  employing 


i 

1 

ill 

n 

I' 


w 


i. . 


iii 


Til 


Iff' 


m 


.J: 


« 


138 


MEDICAL  HKETCUES. 


U'l 


llllll 


i| 


(h«m,  were  strenuously  ohjeclnd  to  hy  the  patient,  bolug  appre* 
hensive  he  was  weakened  by  them. 

He  was  then  put  on  a  course  of  Dover's  powders.  While  en- 
der  their  influence  the  patient  seemed  to  be  in  a  better  condi- 
tion, than  I  had  seen  him.  There  was  sutTicient  ipecacuanha 
in  this  |)rcpnration  to  counteract  the  restrictive  powers  of  the 
opium,  which  was  necessary  to  procure  a  respite  from  pain  ;  al- 
so some  sleep.  By  this  medicinv*^  the  necessity  of  cathartini 
wns  obviated;  at  the  same  time  the  powders  induced  a  gentle 
diaphoresis  upon  the  skin,  universally,  which  previous  to  their 
administration  had  been  dry  and  hard.       :,tr.j  «;  urtr, ,»?  .1  -tiiu  i  > 

AUiinugh  I  could  with  propriety  pronounce  him  in  a  favoura- 
able  condition,  having  more  appetite,  and  less  pain ;  yet  he  was 
very  impatient  under  his  circumstnnci  s.  His  Tncnds  advised 
him  to  invite  a  physician  to  consult  upon  his  case. 

Upon  an  interview  my  plan  was  opposed.  Tlie  bark,  wine, 
spirits,  and  opium  were  proposed  in  large  quantities.  To  these 
1  objected,  under  existing  circumstances.  My  principal  objec- 
tions arose  Trom  the  constipated  state  of  the  bowels  and  rigidity 
of  the  sjihincter  ani.  The  patient  h:id  his  choice.  He  prefer- 
red the  stimulating  process,  as  being  more  congenial  to  his  own 
sentiments,  that  they  were  necessary  to  give  strength,  as  they 
were  more  agreeable  to  his  propensities.  In  consequence  of 
some  indecorous  language  of  the  consulting  physician  who  was  a 
citizen,  I  refused  to  visit  the  Major  again,  in  the  character  of  a 
piiysician.  However,  the  last  stimulating  prescriber  was  event- 
ually dismissed  wi^h  a  load  of  imprecations  from  his  patient,  nf- 
ter  he  had  taken  bark,  wine,  spirits  and  opium,  until  he  was 
disgusted  with  the  sight  of  them,  and  with  no  melioration  of  his 
condition.  These  medicines  had  the  eifect  to  place  his  stomach 
and  bowels  in  an  irremediable  state,  in  which  Doctor  Hunt  found 
them,  when  he  made  his  lirst  visit. 

If  wc  may  be  allowed  to  theorise  in  what  manner  the  acetite 
of  lead  may  act  to  imhice  dropsies,  when  administered  to  pa- 
tients extremely  reduced  by  chronic  diarrhoea,  we  shall  observe, 
that  tlie  increased  evacuations  from  the  internal,  diminished 
those  .upon  the  cxtejmal  surface  of  the  body,    during  the  course 


CAMPAIGN  OP  1814. 


tat 


uf  the  diarrhoea,  the  tkin  waa  remarkably  dry.  Unlcfls  perspira- 
tion wai  restored,  as  diarrhcea  vras  cheeked,  there  was  an  accu- 
mulation of  lymph  in  the  large  and  small  cavities  of  the  body ; 
whence  hydro-thorax,  ascites,  and  anasarca.  Perhaps  there  is 
not  in  the  materia  medica,  a  more  powerful  and  permanent  as- 
tringent, than  sugar  of  leiul.  May  not  this  |iotcnt  medicine  bn 
equally  efficacious  as  an  astringent,  and  less  deleterious,  in  com- 
bination with  some  article  whose  known  effect  is  to  determine 
the  material  of  perspiration  to  the  skin  i  such  ns  ipecacuanha. 
The  tepid  bath  may  be  an  appro|)riate  remedy,  while  the  |)atirnt 
is  under  the  effects  of  the  acetite  of  lend.  The  above  is  8Ui;gest- 
cd  to  those  who  are  persuaded,  that  sugar  of  lead  is  not,  in  any 
ca{|e„an  unsafe  internal  medicine.  Opium  has  been  advised  to 
obviate  the  colic  pains,  which  sugar  of  lead,  freriuently  induces, 
when  continued  a  long  time.  Doctor  Fishicu,  President  of  the 
Massachusetts  Medical  Society,  in  a  commun  cation  published 
with  their  papers,  has  related  several  cases  of  <  olica  pictonuni, 
in  which  opium  in  large  quantilies  was  administered,  nut  only 
with  safety  until  pain  was  overcome,  but  with  happy  effects. 
He  obviated  the  restrictive  powers  of  opium  on  the  iutcatinch;, 
by  some  cathartic  medicine.  In  hemorrlin,«;ic  disr.tses,  as  ms- 
Dorrhagia,  and  hemo-phlhysis,  the  acetite  of  lead  is  now  resorted 
to  as  a  safe  remedy  :  here  a  few  doses  generally  will  cure  IImj 
disease,  without  any  subsequent  bad  effects ;  but  since  expcri- 
encing  that  sulphate  of  copper  is  equally  efficneious  in  these  dis- 
eases, and  in  my  estimation  a  snfer  remedy,  it  is  substituted  in 
my  practice  in  all  those  hemorrhagic  diseases,  where,  formerly, 
the  acetite  of  lead  was  emploj'ed. 


I( 


~H^'i';\r.i 


rn"     <'i    •> 


Rheumatalgia  was  a  frequent  disease  in  the  hospital  at  Bur- 
lington, in  the  winters  of  1813 — 14.  The  patients  dated  the  or- 
igin of  this  complaint  from  some  period  of  the  movement  of  the 
array  from  Niagara  to  French  Mills.  It  has  already  been  notic- 
ed, that  <he  weather  was  rainy,  boisterous  and  cold.  The  men 
vvere  frequently  employed  up  to  their  arms  in  water,  to  secure 


m\ 


I 

n 


140 


MEDICAL  SKETCHES. 


t.,     < 


their  bbats  and  bag|;nge  Troin  being  lost  In  the  surging  surl  when 
they  approached  the  shore  of  the  lake. 

Calomel  and  opium,  or  Dover*!*  powder,  under  different  states 
of  their  diseases,  were  found  beneflcial.  Under  the  most  chronio 
fvrms,  the  following  was  directed. 

R.  Tine,  guaic.   §  I.    i  V   < 
Laud,  liquid.  ^  I.      14  ■<■ 
Vinum  antimon.  ^  i. 
Aqua  Amonia.  5  ii*    m. 
or  the  above  mixture,  a  teaspoonful  was  administered  every  feur 
«r  six  hours.      ••;•..'      w*''"  r'.»  s.  mi   f  <  "  "  .-.-i  •j  • 

In  some  instances,  swelling  of  the  joints  accompanied  this 
oomplaint.  The  camphorated  volatile  liniment  was  used  by 
way  of  embrocation,  and  blisters.  These  diseases  terminated, 
in  some  instances,  in  confirmed  white  swellings,  which  were 
remedied  most  generally,  by  long  continued  applications  of  bits* 
ten  on  the  part  affected,  as  recommended  by  Doctor  Dexter, 
in  his  communication  published  with  the  papers  of  the  Massa- 
chusetts Medical  Society,  and  at  the  same  time^  one  grain  of 
calomel,  combined  with  half  graiu  of  opium,  was  given  night 
and  morning.  "    •    .  -vn        ' '  <^ 

The  steams  rising  from  the  wash-tubs  in  the  hospital  proved 
salutary  to  such  as  were  able  to  exercise  their  bodies  over  them. 
The  rheumatic  patients  were  put  to  the  duty  of  washing  an  hour 
or  two  daily,  which  proved  more  permanently  beneficial,  than 
temporary  immersions  in  tepid  water  ;  and  when  care  was  tak- 
'"t  subsequently  they  did  not  expose  themselves  to  cold, 
steam  baths  proved  a  convenient  remedy.     Some  were 
ared  by  this  employment.    The  spirituous  vapour  bath  of  Doc- 
tor Jennings  was  experienced  an  improved  method  of  commu- 
nicating warmth  to  the  bo<iy,  and  of  equalizing  the  excitement 
throughout  the  system ;  thereby  relieving  the  fixed,  as  well  as 
wandering  pains,  which  constitute  the  above  forms  of  disease. 
His  method  of  practice  was  not  introduced  into  the  hospital  until 
the  close  of  the  war.     '    '         '  *'    '        '^     "•-,'•  -•  '         -^    - 

Syphil'^ic  complaints  we  also  numbered  among  our  diseases. 
Many  0    mese  had  been  of  long  duration,  from  three  to  fifteen 


;   i. 


>  ^1 


111 


CAMPAIGN  OP  laM. 


141 


monthl,  ftnd  were  nccompnnieil  with  nil  the  vnriouB  •ymptomsof 
confirmfd  him.  Hume  or  thene  patients  had  bcrn  in  the  hospi- 
tal leveral  months  previous  to  my  taking  the  charge  of  it,  tvith 
obstinate  chnncres  and  nlcrrs,  arcompan:ed  with  pains  in  ditYcr- 
enl  parts  of  the  hody,  and  cxceeuingly  emaciated.  These  men 
liad  already  gone  tliroiigli  with  repeated  coursi's  of  mercurials, 
under  every  form,  without  any  abatement  of  the  disease ;  to 
vrhich  had  been  added,  tonicd,  bark,  sarsaparillii,  guaicum,  Arc. 
with  little  or  no  benefit. 

After  the  above  reports  had  been  circumntantially  made  by 
the  surgeons  who  last  proBcribed  for  these  patients,  1  believed  it 
useless  to  employ  mercurials,  or  common  medicines  any  further. 
The  reputation,  which  the  nirtro-muriute  of  gold  hnd  acquired  in 
most  obstinate  cases  of  this  disease  in  the  city  of  New-York,  foI> 
lowed  by  favourable  reports  of  its  use  from  Doctor  Low  of  Alba- 
ny, determined  me  to  give  this  last  medicine  n  trial  npon  our 
hospital  patients.  They  all  were  placed  under  the  care  of  hos* 
pital  surgeon's  mate  Walkf.r,  from  whonr.  1  had  the  satisfaction 
to  learn,  within  a  fortnight,  the  greater  part  were  either  entirely 
cured,  or  in  a  happy  way  of  recovery.  In  a  short  time  after  they 
were  all  reported  well.  j  ■  •     ,  -ri-   ^   .-^ 

At  the  close  of  the  year  1S14,  a  patient  placed  hhnsclf  under 
my  care,  wlio  had  peiformed  his  duty  the  whole  campaign  under 
this  disease;  and  while  in  the  use  of  mercurials,  had  exposed 
himself  to  all  the  varying  changes  of  weather.  At  the  time  I 
was  called  to  advise  in  his  case,  there  was  upon  the  glans  penis 
an  obstinate  nicer,  which  had  destroyed  half  of  it ;  while  tha 
chancre  continued  to  progress.  The  patient  was  directed  to 
take  a  pill  composed  of  bread  and  Jth  grain  of  the  nitro-muriate 
of  gold,  night  and  morning.  The  ulcer,  in  a  few  days,  assumed 
a  healthy  appearance,  and  healed  in  three  weeks. 

The  winter  following  a  second  patient,  who  had  exposed  him* 
leir,  during  the  preceding  campaign,  while  taking  medicine  for 
the  cure  of  a  syphilitic  disorder,  asked  my  advice,  on  account 
of  an  ulcer  in  his  groin,  of  four  months  duration;  when  he  was 
•nlered  the  nitro-muriate  of  gold  ;  which,  rn  sevea  days,  chang* 
...     ,  19 


i4lll«iHI 


:'l#li' 


II,.' 


'r\ 


142 


MEDICAL  SKETCHES. 


n 


lil 


! 

4'i 


€(1  its  appearance  Tor  the  better ;   and,  in  the  course  of  fourteen 
days,  completely  efTected  a  cure.         ,  .,„(.>.. 

Phthisis  pulraonalis,  in  a  few  instances,  followed  the  winter 
epidemic,  denominated  pneumonia.  It  generally  had  a  fatal  ter- 
mination. Life  was,  in  some  instances,  prolonged  by  a  soft  nu- 
tritious regimen,  wine,  and  diluted  brandy.  Hope  of  recovery 
\ras  always  entertained  by  the  patient  to  the  last  expiring  mo- 
ment. Such  was,  as  has  ever  been  described,  this  insidious  and 
flattering  disease.  -.'i.i 

At  the  commencement  of  the  war,  most  unfavourable  repre- 
sentati'  ^s  were  publicly  made,  of  every  department  of  the  army. 
The  medical,  in  connexion  with  others,  was  exhibited  in  re- 
proachful language.  The  bad  management  of  hospitals  was  a 
subject  of  severe  animadversion.  The  physicians  and  surgeons 
of  the  army  were  either  ignorant  of  their  professions,  or  inatten- 
tive to  their  duly.  The  distresses  of  the  sick  were  portray- 
ed in  gloomy  colours.  The  number  of  deaths  in  consequence  of 
disease,  although  the  mortality  was  great,  was  vastly  exaggerated. 

Such  were  the  statements  given  to  the  public,  by  characters 
oppof'd  to  the  war;  the  object  of  which  was,  to  defeat  the  meas- 
ures of  the  government,  by  di?couraging  the  recruiting  of  the 
army. 

Man,  under  all  situations,  is  subject  to  disease  and  its  concom- 
itant evils.  That  the  soldier  in  the  field  is  more  exposed  to  dis- 
asters, than  the  citizen  at  his  ease,  is  believed  and  acknowledg- 
ed by  all.  Candour  would  have  made  allov  ances  for  the  extra- 
ordinary mortality,  which  has  visited  the  army,  and  not  have 
imfplicated  the  officers  of  the  medical  department,  nor  the  im- 
providence of  government,  as  being  instrumental  to  these  scenes 
of  distress. 

It  should  be  remembered,  that  in  addition  to  unavoidable  ex- 
posures of  the  army,  during  long  rapid  marches,  and  water- 
transportations,  as  well  as  tiie  other  duties  of  the  camp  and  field, 
as  being  causes  of  sickness  and  deaths ;  a  consi(|l.erabIe  proper* 
tion  of  the  soldiers,  when  enlisted,  were  either  too  old  or  in- 
firm to  endure  those  fatigues.  Many  of  them  became  fit  sub- 
jects for  hospitals,  as  soon  as  they  commenced  their  military  eer 


CAMPAIGN  OF  1814. 


143 


vices.  This  last  circumstance  was  an  evil  more  especially  of 
the  first  campaign,  when  a  healthy  young  man  would  not  en- 
gage in  the  army,  where  dangers  in  many  shapes  assail  him,  for 
a  less  compensation  than  he  could  receive  in  domestic  employ- 
ment, safe  from  harm,  and  no  way  exposed  to  severe  hardships. 
Wherefore  many  men  were  mustered  as  loldiera,  who,  in  conse- 
quence of  bad  habits,  and  intirm  constitutions,  cmdd  find  no  oth- 
er employment. 

When  the  numerous  decrepid  men,  of  whom  our  array  has  been 
composed,  are  taken  into  consideration,  the  number  of  deaths 
were  fewer  than  might  have  been  expected,  by  those  acquainted 
with  these  facts;  and  we  are,  notwithstanding  all  the  inconven- 
iences to  which  the  sick  were  subjected  in  tii^  camp  and  fields 
persuaded,  even  during  the  extreme  mortality  of  the  v  inter  1812 — 
lU,  the  number  of  deaths  in  the  army  did  not  exceed,  propor- 
tlonably,  the  number  among  citizens  in  any  dislrict  where  the 
epidemic  prevailed ;  but  much  less  than  in  some. 

Had  these  mortal  visitations  been  confined  to  the  army,  those 
who  have  reasoned  themselves  into  a  belief,  that  the  war  was 
unjust,  might  with  some  propriety  have  proclaimed,  that  divine 
providence  in  wrath  executed  judgment,  and  inflicted  retributive 
justice  upon  the  aggressors.  It  was  not  only  absurd,  but  impious, 
to  assign  for  events  subject  to  divine  control,  the  feeble  agency 
of  man.  Such  is  the  pestilence  which  walks  in  darkness,  and 
exhibits  its  progress  only  by  its  direful  effects. 

Independent  of  diseases  produced  by  pestilential  states  of  at- 
mosphere, there  were  periods  when  the  condition  of  the  soldier 
was  wretched.  On  the  field  of  battle,  tortured  by  the  anguish 
of  his  wounds — during  inclement  seasons,  exposed  to  frosts  and 
raging  storms — while  preparing  quarters  for  winter,  in  wild  and 
frigid  regions — the  hardships  of  a  so  lierarepevere.  Such  were 
his  sufferings;  such  were  his  painful  toils  and  labours  on  extra- 
onliuiiry  occasions.  Such  were  the  sacrifice^  he  made  for  the 
public  good.  His  country  demaiidci  them  of  him-  Similar 
were  the  sacrifices  made  during  tha  revolutionary  war.  Then 
the  offerings  ou  the  altars  of  Liberty  were  honorably  noticed. 
Theathe  memory  of  the  self-devoted  hero  was  cherished,,  while 


I. 'I 


'/ 


III 


y  s! 


V 


!MI 


III 


nv    i    -H 


U4 


MEDICAL  SKETCHES. 


his  hard  fate  was  lamented.  At  that  momentous  period,  when 
the  nation  was  contending  Tor  her  Liberties  and  Independence^ 
the  sufferings  of  her  armies  were  severer  than  in  the  last  war, 
equally  struggling  with  a  powerful  enemy  for  her  rights.  Dur- 
ing the  adventurous  times  of  the  first,  the  sensibilities/and  pas- 
sions of  the  people  were  not  excited  to  counteract  the  just  meas- 
ures of  the  government,  to  oppose  the  violent  aggressions  of  a 
savage  and  infuriated  enemy. 

The  exaggerated  accounts  of  deaths  on  the  northern  frontiers, 
and  in  the  hospital  at  Burlington,  with  which  some  of  the  weekly 
papers  were  pregnant  during  periods  of  the  war,  have  meverbeea 
contradicted.  I  have  to  regret  that  few  of  the  official  reports  of 
the  general  hospitals  are  to  be  found.  Copies  of  those  made  at 
Malone,  near  the  French  Mills,  and  at  Burlington,  for  the 
months  of  January,  February,  March  and  April,  of  1814,  are 
all  which  are  at  this  time  in  my  possession.  Into  these  hospi- 
tals, the  largest  proportion  of  the  sick  of  the  army  were  admitted, 
after  the  close  of  the  unfortunate  campaign  of  1813.  While  the 
army  were  in  cantonments  at  French  Mills,  the  sick,  as  soor 
as  hospitals  were  established,  were  ordered  to  Malone.  After 
the  army,  udder  the  immediate  command  of  General  Wilkinson, 
and  the  division  of  General  Hampton,  retrograded  from  the  lines 
of  Canada,  the  sick  were  generally  sent  to  Burlington  hospital, 
except  those  attached  to  the  division  of  General  Brown,  who 
were  ordered  from  the  Mills  to  Sackett's  Harbour. 


:\ 


An  abstract  of  the  hospital  report  of  the 
sick  at  Malone,  from  1st  Jan.  to  9  th  Feb 
1814,     --_--. 
Report  at  Burlington  for  January, 
Do.  for  February, 

Do.  for  March, 

Do.  for  April, 


There  remained  in  the  hospital  at  Burlington  upon  the  30th 
April,  IGl  patients,  not  50  of  whom  required  medical  aid. 


Adnuttcd. 

Deaths. 

380 

20 

180 

7 

671 

17 

931 

29 

630 

22 

M 


CAMPAIGN  OF  1814. 


145 


From  the  first  of  May  to  the  last  of  July,  1814,  the  numbers 
on  the  sick  reports  weekly  diminiahed.  For  the  month  of  June 
or  July,  (which  I  do  not  now  recollect,)  not  one  death  was  re- 
ported, at  Ghazy  and  Champlain,  when  the  strength  of  the  army- 
exceeded  6000  men.  It  was  not  until  the  middle  of  August, 
that  our  old  visitors,  dysentery  and  diarrhooa  made  their  appear- 
ance among  the  troops.  ■'.    '. 

When  the  army  under  the  command  of  General  Izard  retro- 
graded from  Champlain  to  Plattsburgh,  the  la^t  week  in  August, 
and  continued  its  route  to  Sackett's  Harbour,  the  sick  of  that  di- 
vision were  left  at  Plattsburgh,  under  my  direction,  with  only 
one  assistant  capable  of  duty.  Upon  the  1st  of  September,  the 
returns  of  the  sick,  including  the  regimental  and  hospitals  re- 
ports, were  921. 

The  British  army  followed  General  Izard'b  retrograde  march. 
Upon  the  6th  of  September,  Plattsburgh  was  invested  with  an 
army  of  between  14  and  15,000  men;  when  the  sick  unable  to 
perform  garrison  duty  were  ordered  to  be  transported  to  Crab 
Island,  about  two  miles  from  the  fortifications ;  as  they  could 
not  be  covered  within  the  lines  of  defence.  At  this  time  the 
general  hospital  reports  alone  counted  720  men. 

General  M'Comb,  learning  that  General  Prevost,  Commander 
in  Chief  of  the  British  forces,  was  in  full  march  over  the  line,  had 
no  doubt  this  powerful  army,  with  the  co-operation  of  the  fleet, 
was  destined  to  take  possession  of  the  post  at  Plattsburgh; 
which,  at  that  time,  was  the  depot  of  the  munitions  of  war,  for  an 
army  of  ten  thousand  men,  and  which  no  time  was  had  to  re- 
move, after  General  Izard  marched  to  the  west. 

The  day  previous  to  the  investment  of  the  post,  General 
M'CoMB  ordered  a  detachment  of  300  men  under  the  command 
of  Major  Wools,  to  cross  the  Sarenac,  and  advance  upon  tlie  en- 
emy, who  were  met  at  Beeckman's  town,  distant  eight  miles.. 
Major  Wool*  fell  back,  skirmishing,  until  he  arrived  at  the  low- 
er bridge  over  the  Sarenac,  where  its  passage  was  disputed  from 
ten  o'clock  in  the  morning  until  evening.  Here  Lieutenant 
KuNT  received  a  mortal  wound  while  emploved  iu  taking  up 


n 


I 


! 

'ill 

ni-l 

I 

i 

! 

♦ 

i] 

• 

i 

! 

i 

' )!' 

J 

iM  ' 

T 


140 


MEDICAL  SKETCHES. 


;'t  1 


u 

I 


the  planks  of  the  bridge ;  uhich  he  survived  two  days  {  the  only 
officer  of  the  army  killed  during  the  investment.  ^  -^ 

Between  the  6th  and  10th,  feints  were  made  by  the  British  to 
cross  the  river  at  the  several  fortling  places ;  in  consequence  re*^ 
peatcd  skirmishings  took  place  between  the  light  troops. 

On  the  10th,  the  enemy  fell  back  from  the  river,  and  firing 
ceased  between  the  advanced  piquets  of  the  hostile  armies  pre* 
paratory  to  the  ensuing  attack. 

On  the  1 1  th,  the  British  fleet  under  the  command  of  Commo- 
dore DowNiE,  bore  down  upon  Commodore  MACDONouan.  At 
the  same  time  the  enemy,  with  a  division  of  2000  men,  evinced 
hia  determination  to  cross  the  river,  five  miles  south  of  the  forti- 
fications. He  gained  the  southern  bank  without  much  opposi- 
tion. The  enemy,  having  advanced  its  column  about  one  mile 
from  the  river,  was  met  by  the  volunteers  from  Vermont,  under 
General  Strong,  and  the  drafted  militia  of  the  northern  counties 
of  New  York,  under  the  command  of  General  Moeres.  The 
enemy  retreated  with  considerable  loss  in  killed,  wounded,  and 
prisoners ;  and  recrossed  the  river  with  precipitation. 

During  this  gallant  resistance  made  by  the  volunteers  and  mi- 
litia, a  heavy  tire  was  opened  from  seven  batteries  upon  the  for- 
tifications, some  of  which  within  the  distance  of  400  yards. 
These  movements  and  operations  on  land  were  simultaneour> 
Avith  the  attack  of  the  British  Commodore,  upon  the  fleet  under 
the  command  of  Commodore  Macdonough. 

These  combined  assaults  exhibited  one  vast  military  effort  oi 
the  British  general  to  gain  the  ascendency  of  the  waters,  and  the 
borders  of  Lake  Champlain.      ..  „  ';,.:..>, 

The  tire,  which  was  unceasingly  vomited  from  the  mouths  of 
two  hundred  pieces  of  cannon,  was  terrible.  The  whole  exhibi- 
tion on  water  and  land,  in  addition  to  the  uninterrupted  cracks 
of  musketry,  in  the  forests  south  of  the  fortifications,  to  a  specta- 
tor in  full  view  of  the  fleets  and  batteries,  was  awfully  grand. 

The  army  of  General  M'Comb  seemed  regardless  of  the  can- 
nonade against  themselves  ;  but  were  interested  spectators  of 
the  conflict  on  the  lake,  looking  forward  to  the  event  with  ex- 
treme anxiety,  well-knowing,  that  the  security  of  this  important 


CAMPAIGN  OP  1814. 


U1 


post  much  depended  on  the  success  of  the  fleet.  Two  full  hours 
victory  was  held  in  suspfjnse  ;  when  an  huzza  on  board  the  ship 
Saratoga  announced  its  victory  over  its  antagonist  the  British 
Commodore^s  sfaip,  the  Confiance.  The  brilliancy  of  this  ac- 
tion was  never  surpassed,  especially  as  the  event  was  of  the 
highest  importance  to  the  nation. 

It  belongs  to  the  historian  to  do  ample  justice  to  the  com- 
manders  of  the  land  and  navy  forces ;  who  directed,  under  Prov- 
idence, the  destinies  of  that  day.  These  transactions  are  here 
noticed,  as  being  connected  with  the  general  movements  of  the 
several  divisions  of  the  army  on  the  frontiers. 

This  memorable  action  gave  full  employment  to  the  surgeons 
of  the  army  and  navy.  The  wounded  of  both  fleets,  as  well  as 
the  army,  were  ordered  to  Crab  Island  encampment,  under 
my  immediate  charge.  Within  four  days  more  than  thirty  am- 
putations were  performed  on  the  United  States^  troops  and  sea- 
men, and  the  British  prisoners  of  war.  A  variety  of  gun-shot 
wounds  came  under  my  observation ;  some  of  which  will  be  re- 
corded, as  being  important  to  the  young  surgeon. 

It  is  worthy  of  remark,  that  the  convalescents  of  the  army, 
after  this  glorious  victory,  recovered  their  healths  in  a  rapid 
manner.  This  was  most  evident  among  a  number,  who  had 
been  ordered  into  the  fortifications,  at  the  time  the  post  was  in- 
vested. These  men  suffered  no  inconvenience  from  exposures 
day  and  night  without  tents,  although  it  rained  part  of  the  time. 
Similar  occurrences  have  been  noticed,  as  effects  of  exhilirat- 
ing  excitements  on  the  mind,  pn  luced  by  important  victoria 
over  an  enemy. 

It  has  been  before  noticed,  that  diseases  of  the  bowels  first  ap- 
eared  in  this  campaign  about  the  middle  of  August.  The  troopR 
previously  had  not  been  subjected  to  hard  duty,  until  the  earth 
was  dry.  The  preceding  campaign  the  troops  were  attacked 
with  the  same  complaints  in  the  month  of  May,  the  men  having 
been  put  on  most  severe  duty,  as  early  as  March.  Having  an 
opportunity  this  campaign,  to  see  men  sick  with  these  diseases, 
during  the  first  stage  of  indisposition ;  it  was  learnt,  they  super- 
vened, without  a  loss  of  appetite  on  their  first  attack,  and  when 


r^ 

TWP 

■1 

tU  iai  M 

1 

■III 

M 

llli 

H  [ 

'■■I: 

■■ 

till, 

w 

IHff'J 

Nf 

i  I 


•!:l 


^T 


m^m'  9 IV 


148 


MEDICAL  SKETCHES. 


f , 


1  - 


immediately  attended  to  were  readily  removed.  Soldiers  gefi? 
erally  did  not  report  themselves  siclc,  while  they  were  able  to 
take  their  common  rations,  which  orten  were  c^evoured  with  im- 
paired appetites.  The  Consequences  were  totelindigestion,  loss 
of  appetite,  and  gradual  increase  of  their  hov/et  complaints.  To 
these  sypmtoms  were  added  increase  of  lieat  and  dry  skin. 
Where  these  derangements  of  the  fuc&tions  were  not  obviated, 
fever  deteriorated,  and  assumed  a  typhoid  ibrm.  These  fevers 
became  typhous,  also,  where  attempts  were  made  to  check  the 
iliarrhaea  by  early  administration  of  astringents  and  stimulants ; 
more  especially  ardent  spirits  and  opium,  previous  to  evacuating 
the  stomach  and  bowels  by  emetics  and  cathartics.  When  high* 
ly  excited  by  ardent  spirits,  these  complaints  were  accompanied 
with  accelerated  action  of  the  arteries,  and  assumed  a  synochal 
form  of  fever,  wherein  bleeding  was  indicated*  ;  ;,)  ji;  nn;;  i  7.^. 
The  diseases  of  this  campaign,  as  has  been  noticed,  did  not 
supervene,  until  the  greatest  heat  of  summer  had  commenced. 
We  know  from  experience  that  transitions,  from  one  temperature 
to  another  when  sudden,  induce  unequal  excitement  in  the  sys- 
tem. This  effect  was  most  evident,  when  the  body  was  envel- 
oped in  a  moist  atmophere.  Subjected  to  rains  and  cold  fogs, 
the  pores  of  the  body  become  impervious  to  the  matter  of 
perspiration,  caused  by  loss  of  heat  upon  the  surface,  then 
by  a  collapse  or  spasm  of  the  minute  vessels  of  the  skin.  TIip 
glands,  subservient  to  the  secretion  of  the  perspirable  matter, 
cease  to  perform  their  offices.  The  other  secretory  org.uis,  by 
association,  are  also  deranged.  The  liver  partakes  of  this  gener- 
al affection,  and  neglects  to  execute  its  appropriate  functioni'< 
made  most  evident  by  the  appearance  of  the  faecal  evacuation?, 
which,  in  simple  diarrhoea,  were  generally  white  or  clay  colour- 
ed ;  the  dejections  accompanied  with  griping  pains  and  tenes- 
mus, were  dark,  sanious,  slimy,  and  streaked  with  blood.  These 
several  appearances  depend  on  degrees  of  derangement  within 
the  intestines,  and  morbid  secretions  of  inflamed  vessels ;  not  on 
states  of  the  bile.  !.<'or  want  of  digestion,  every  article  of  food 
taken  into  the  stomach  was  converted  into  an  irritating  material, 
which  induced  inflammation  on  the  villous  coats  of  the  bowels, 


CAMPAIGN  OP  1814. 


141 


nvhich  were  vellicated,  more  or  leM  proportionate  to  the  de;rea 
€f  the  deleterious  power.  Dejection!  of  a  natural  colour  were 
favourable  appearances,  inaamuch  as  they  demonstrated  that 
the  liver  still  continued  to  perform  its  secretory  offices.  When 
these  dejections  were  accompanied  with  large  secretions  of 
bile,  from  its  superabundance  leas  (hinger  was  apprehended, 
than  Avhen  there  was  no  evidence  of  bile  in  the  evacuations ; 
the  bile  it  is  believed  may  prove  salutary  by  washing  from  the 
intestinal  canal  offending  materials.  After  a  similar  manner, 
a  flood  of  tears  wash  irritating  materials  from  the  eyes.  These 
salutary  effects  of  bile,  a  cathartic  furnished  by  nature,  have 
long  since  been  noticed  by  physicians,  inasmuch  as  bilious 
diarrhoeas,  frequently  accompany  the  resolution  of  acute  dis* 
eases. 

That  these  diseases  of  the  intestines  were  accompani«3d  with 
inflammation  of  their  internal  coats,  was  inferred  from  pain,  ten- 
esmus, mucous  evacuations,  heat  and  soreness  at  the  inferior 
portion  of  the  rectum;  and,  especially  from  dissections  of  some 
who  were  victims  to  these  diseases. 

During  the  wet  season,  which,  this  campaign,  commenced  the 
last  of  August,  and  continued  into  September,  it  was  not  possi- 
ble to  treat  these  diseases  with  success,  while  the  sick  were  ia 
tents.  These  complaints,  under  such  exposures,  frequently  run 
on  a  length  of  time,  and  become  habitnal ;  and  under  a  chronic, 
form,  were  obstinate,  and  resisted  ail  remedies ;  white  the  pa- 
tients were  exposed  to  rains,  and  the  night  fogs  of  the  lakes.  The 
most  efficient  remedy,  employed  under  my  observation,  for  these 
habitual  diarrhosas  of  the  bowels,  was  Dover^s  powders  repeated 
every  four,  six,  or  eight  hours,  as  the  symptoms  demanded.  It 
was  now,  as  heretofore  experienced,  a  safe  and  frequently  an  effi- 
cient medicine,  productive  of  no  new  disease.  Whereas,  when 
these  diseases  were  suddenly  checked  by  astringents,  and  espe- 
cially by  acctile  of  lead,  dropsical  swellings  supervened. 
Chronic  diarrhoeas  were  cured  with  the  greatest  safety  by  such 
medicine  as  promoted  perspiration,  combined  with  those  which 
were  pacific,  and  took  off  irritation.  To  this  intention,  Dover's 
powder  was  admirably  adapted.  To  possess  the  full  effects  if 
20 


.i;l 


'f 


!i^. 


r  r  ^' 


I 


II : 


III 


150 


MEDICAL  SKETCHES. 


this  powder,  or  any  appropriate  medicine,  the  patient  should  be 
placed  in  a  dry  situation,  kept  warm,  and  fed  with  a  soft  farina- 
ceouB  diet.  Perhaps  nothing,  as  nutriment,  was  preferable  to 
milk  and  its  soft  preparations.  When  the  patients  were  re- 
duced by  excessive  evacuations,  stimulants  were  highly  impor- 
tant  to  support  the  powers  of  life,  such  as  wine  and  diluted 
spirits.  To  these  were  added  anodynes  at  night ;  and  ia  some 
cases  frequently  repeated  through  llie  day.  .    !  h'  ::      >: 

I  have  always  experienced,  that  even  after  a  return  of  appe- 
tite, animal  nutriment,,  prepared  in  the  softest  manner,  was  not 
well  adapted  to  restore  the  convalescents  from  this  disease  to 
health.     The  last  observation  is  not  confined  to  army  practice. 


ill 


'  :ir'ij 


GENERAL   CURATIVE    INDICATIONS. 

Ist. — To  remove  the  irritating  causes  of  inflammation  from  the 
bowels; 
'A.  by  evacuations.  ,  . ,  ,j  ,,  ,, 

ft.  emetics ;  ^  , ,  <  » j  i ,      .,,'.■•  > '.   " ,  .^  . '.  » i » •  I ,'  i  * 

b.  cathartics.  , 

B.  By  restoring  to  tlie  skin  its  secretory  offices,  by    , , 

a.  avoiding  cold  and  wet  J    ■    ...li    .  ,    !«    /    ;. 

b.  tepid  baths;    ,    ;.     ,.>;!.      i.'  ^.  •        !•  h;    i  -  1 

c.  mtidicine,  which  determine  to  the  surface ;  or  promote 
J,.  ^  ,.  perspiration;  Dover's  powder. 
<To  counteract  irritation,  tbe  cause  of  griping  pains  ;  by 

medicines,  which  are  more  efficient  after  suitable  evac* 
nations; 
I,       A.  by  sedatives,  as  .  .       ' 

a.  opium;  ,    .: 

b.  tine,  of  hops;  .    ,     ,.    ,     ,;    • 

c.  mucilages. 

3d.— To  give  tone  to  the  stomacb,  and  promote  its  digcslivi: 
powers:  ■  '  .    -  , 

A.  by  Astringents ;  always  to  be  employed  with  caution ; 

a.  bark ;  seldom  the  most  suitable  ; 

b.  vegetable  bitters ;  /  •,, 
c  aromatics;                          ,  , 


x\ 


2d.— 


■1 


.'  ■^'>  -■; 


VI*  1 


CAMPAIGN  OP  1814. 


rjij 


fK 


B.  by  stimulants,  as 

a.  ardent  spirits ;    i    '  *       .  uU'        n  ■     ■  * 

b.  vinous  liquors ;  '  *    '  »■,        i    • 
'    i-i,  C.  by  nutriment,  at  jn' *      '    •. 

a.  farinacea,  and  their  preparations ; 
>    b.  milk,  and  its  several  preparations  more  beneficial,  than- 
,<0  most  kinds  of  nutriment ; 

>;ut  c.  animal  nutriment;  prohibited  until  the  diseased  organs 
*'  ■  *  are  restored  to  their  healthy  actions. 
It  has  been  observed,  that  typhous  fever  sometimes  accompa- 
nied these  complaints  of  the  bowels.  This  form  of  disease  re> 
quired  some  additional  treatment.  The  following  were  its  most 
conspicuous  symptoms.  Hot  and  dry  skin ;  pulse  not  fuller  than 
in  health,  but  accelerated  f  eyes  suffused  with  blood ;  tongue 
brown  and  dry.  These  symptoms  were  accompanied  with  pain 
in  the  head,  and  throughout  the  dorsal  muscles,  and  the  extrem- 
ities. The  patient  when  moved,  complained  of  soreness  through- 
«ut  the  body.  Delirium  or  coma,  sometimes  accompanied  the 
febrile  state,  and  shewed  that  the  brain  partook  of  the  general 
derangement. 

After  evacuating  the  stomach  and  bowels,  by  emetics  and  ca- 
tliartics,  the  following  formula  was  adopted  in  liospital  practice 
with  much  success. 

.'  '       !  R.  Calometgr.  y. 

"'  •    Opium  gr.  v.  , 

'  :     S     '  Tart.  Ant.  gr.  ii. 

Misce,  fiant  put.  x.  capiat,  una,  quaque  secunda  vel  tcrlia  hora. 
By  the  employment  of  tho  iibove  medicine,  the  skin  became 
soft;  the  tongue  moist;  and  pain  in  the  head,  b^^ic,  and  extrem- 
ities abated.  When  delirium  supervened,  blisters  upon  the  neck 
and  head  itrere  necessary;  as  were  sinapisms  to  the  soles  of  the 
feet.  In  some  cases,  ipecacuanha  was  substituted  for  the  tartrite 
of  antimony,  in  the  above  formula ;  especially  when  the  antimony 
irritated,  or  ran  ofif  by  the  bowels. 

After  a  resolution  of  fever,  known  by  a  gentle  diaphoresis,  a 
moist  tongue,  and  a  removal  of  delirium ;  or  where  a  coldness 
supervened,,  stimulants  were  introduced.     A  mixture  of  spt.  iut> 


>lill1 


lii 


Ia><( 


m 


fi 


iWi 


m 


\m 


! 


■:H 


f;;  i'l 


15^ 


BIEDICAL  SKETCHES. 


tlul.  five  parlB,  and  aqua  nmmonia  oire  part,  vra»  hcrr;  enl;iIoye(i ; 
also  r,|)t.  lavcnd.  comp.  and  a  decoction  oT  serpent  virgin,  (nris- 
iolochia  scrpentaria)  likewise,  line.  cort.  comp.  and  wine.  As 
Hoon  as  the  slomacli  ^vas  capable  or  receiving  the  bark,(cinehon.) 
in  powder,  it  became  an  important  remedy.  But  when  the  bark 
in  substance  offended,  its  inrusion  or  oomfiound  tincture  was 
substituted  ;  and  in  cases  where  tlie  bark  did  not  agree  with  the 
•tonuch,  coiombo  root  was  employed  with  advantage.  Anodynes 
eould  not  be  dispensed  with  in  the  last  stages;  and  in  states  of 
irritability  induced  comiiosure  and  sleep,  which  seemed  to  re- 
fresh  the  patient. 


/. 


The  following  report  of  the  state  of  disceaes  at  Bttrlington,  Vcr* 

mont,  in  the  mttunutt  1814,  was  made  hy  Hospital  Surgeotis 

niatCy  PuRCELii. 

*•  In  consequence  of  the  precipitate  removal  of  the  sick  to 
Crab  Island,  in  conformity  to  the  orders  of  General  Mc^Comb  of 
the  5th  of  September,  the  day  (irevious  to  the  investment  of 
Plattshurgh  by  the  British  army  ;  no  straw  was  procured  for  their 
accommodation.  The  sick  were  consequently  lodged  andfr 
tents  upon  wet  ground,  during  two  or  ihree  days  of  wet  weather, 
'when  straw  was  furniahed  from  Grand  Island  in  lake  Champinin. 

"  Many  of  the  troops  were  labouring,  at  this  time,  under  fe- 
vers of  different  forms  ;  and  diarrh<Bns.  The  bad  state  of  the 
sick,  with  their  wretched  accommodations,  made  it  an  otyect  of 
high  importance  to  remove  them  to  a  situation  more  comforta- 
ble. As  the  larger  transports  on  the  lake  were  employed  in 
transporting  warlike  stores,  no  means  were  provided  to  convey 
(he  sick  to  Burlington  Hospital,  a  distance  of  25  miles,  across 
Mie  lake.  Apprehensive  that  the  sick  v^ould  fall  into  the  hands 
of  the  enemy,  exposed  as  they  were ;  and  which  must  have  been 
the  case,  had  he  gained  the  ascendency  on  the  lake ;  it  was 
fu^jgested  to  transport  as  many  as  were  able  to  be  moved  in  op- 


CAMPAIGN  OF  1814. 


1&3 


•n  balteaui  to  Burlington.  The  weather  hnd  been  bofnterous, 
and  paisage  unaafe  in  email  lioatii ;  but  providentially,  (lie  winds 
subsided,  and  the  waters  became  sniootli ;  so  that  they  arrived 
on  the  opposite  shore  witiiout  any  unpleasant  accident  in  small 
detachments;  the  last,  on  the  day  of  the  memorable  action,  he- 
tween  the  fleets. 

"  The  patients,  at  Burlington,  found  comfortable  accommo<la- 
tions;  their  number,  at  this  time,  amounted  to  815  ;  60  of  whom 
were  wounded.  The  evils  arising  from  crowded  wards  were 
soon  perceived ;  but  could  not,  under  existing  •ircumstances,  be 
remedied.  Evf  ^y  precaution  was  employed  to  keep  the  rooms 
clean  and  ventilated ;  but  the  sicic  were  slow  in  their  recovery ; 
while  the  diseases  of  some  became  worse. 

**  Typhu^,  dysentery,  and  diarrhoea,  in  most  cases,  were  so 
combined,  it  was  with  diiiculty  determined,  which  was  the  pre- 
dominant  disease. 

"  The  men  had  been  so  reduced  by  long  sickness,  repeated 
removals,  and  exposures  for  eight  or  ten  days,  that  evacuations 
could  not  be  employed. 

"In  cases  where  dysentery  was  the  prevalent  symptom,  the 
patient  had  more  or  less  fever.  Frequent  inclination  to  stool, 
tenesmus,  gripes,  soreness  at  the  sphincter  ani  were  the  common 
symptoms.  The  discharges  were  a  mixture  of  blood  and  mu> 
cus.  But  as  the  disease  progressed,  the  symptoms  were  more 
aggravated.  The  fever  assumed  a  typhoid  type,  with  total  loss 
of  appetite,  great  thirst,  parched  brown  tongue,  sordes  on  the 
teeth,  increased  heat  of  the  skin — and  in  the  last  stage,  sores  on 
the  nates,  hips,  and  os  sacrum,  so  deep  as  to  expose,  in  some  ca- 
ses, the  bones. 

"  In  the  milder  forms  of  the  disease,  a  cathartic  and  emetic 
were  beneficial ;  and  followed  with  a  soft  nutritious  diet,  the  pa- 
tient soon  recovered.  This  happy  termination  of  the  disease 
was  not  very  frequent. 

"  In  the  severer  forms,  a  repetition  of  a  cathartic  was  found 
necessary.  After  which  were  administered  lartrite  of  antimony 
and  nitre,  in  small  doses,  frequently  repeated.  This  medicine, 
with  tepid  diluks,  while  the  patient  was  couQned  to  his  bad  be- 


^mi\j\ 


\  '■' 

1  > 


T     : 


'^ 


164 


MEDICAL  SKETCHES. 


• 


ii) 


tweon  l)lankc(0,  frequently  brought  oa  a  Tree  perspiration ;  by 
Avhicli,  the  patient  found  himself  relieved  from  all  the  attendant 
lymploms  of  diHease.  But,  \v]«ere  no  ease  was  procured  hy  the 
•hove  means,  an  anodyne,  the  following  night,  was  proper  and 
advantageous,  and  seemed  to  etTect  all  which  had  been  wishiMl 
fur  by  the  precedin*^  medicine.  I|)ecacuanhH,  oo  much  recoiiv 
inended  by  authors  in  this  disease,  was  seldom  of  any  use  unless 
U  was  combined  with  opium  in  the  form  of  Dover's  powder. 

"  Where  the  sick  were  extremely  reduced,  and  no  apparent 
relief  was  obtained  by  active  medicine,  and  efforts  of  some  du- 
ration to  evacuate,  accompanied  with  tenesmus  and  violent 
gripes,  Yijere  fruitless ;  injections  composed  of  arrow  root,  water, 
and  laudanum,  ^vere  found  very  beneficial,  agreeably  to  the  fol- 
lowing formula: — To  half  a  pint  of  water  were  added  a  table- 
spoonful  of  arrow  root  and  sixty  drops  of  laudanum.  The  fore- 
going enema  was  thrown  up  the  rectum  three  or  four  times  a  day. 
It  removed  the  tenesmus  and  gripes,  and  Communicated  to  the 
l)owels>  a  soolhing  sensation,  by  overcoming  the  spasms,  a  con- 
sr(|Uoncc  of  extreme  irritability  of  the  intestines,  more  particu- 
lariy  the  rectum. 

"  When  dysentery  was  accompanied  with  typhous  fever,  ac- 
companied with  great  heat,  no  prescription  seemed  to  fulfil  our 
luu'ative  intention,  of  equalising  the  excitement,  so  well  at  the 
following:—  •    -  >      ' 

"R.  Sal.  nit.  5  i. 
.  ,1,,,    .:  ,  Tart.  Antim.  gr.  iii.      » 

,.i  .!     Gum  Opium,  gr.  vi. 

-.)    (,..;  i»   .->  t  Calomel,  gr.  viii. 

Mlsec,  divide  in  chart  x ;  capiat,  una,  quaque  lerlia  Iiora. 
•    '■  This,  with  soft  nutritious  drinks,  was,  in  most  cases,  follow- 
ed by  salutary  eflbcts ;  a  reduction  of  heat,  soft  skin,  >  ad  moist 
tonguo  and  moutii. 

•'  The  common  saline  mixture  was  albO  administered.  Afr 
ioon  as  the  fever  subsided,  and  the  stools  became  less  frequent, 
and  of  a  more  natural  appearance,  tonics  combined  with  refrig- 
erants were  resorted  to. 


IJAMPAIGN  OF  laU. 


I5ih 


,ui,j««i  .  >' i*     "  R.  Sulphas  martis   3  "'•       ••    '  ^  • 

;..>i,];     .1     .  ,.       8pt.  nit.  dulcia   ^  M.        •,  <  <    i      ' ' 

■  ;.  \^^  ,  »•<      Carbon.  potMsa;  5  **•  *  ' 

A<iua  commun.   f^  bb.         fiat  flolutio. 

*^  or  (he  above,  a  table-spounrul  was  administered  every  three 
or  four  liuurs. 

"  If,  in  this  combination  of  disease,  the  Febrile  symptoms  were 
only  attended  to,  and  the  state  of  the  bowels  neglected,  little 
was  eflected  to  remove  the  general  com|>laints  ;  and  unless  they 
were  very  mild,  the  disease  in  a  majority  of  cases  proved  mortal. 

"As  soon  as  fever  subsided,  and  the  evacuations  became  nrore 
natural,  an  infudien  of  Colombo  root  became  an  appropriate  med- 
icine; and  if  the  patient  was  reduced,  wine  or  diluted  brandy 
was  directed.  An  anodyne  pill  at  night,  even  in  tlup  state,  was 
necessary. 

"  The  utmost  caution,  as  to  the  dietetic  management,  was 
highly  necessary.  Nature  was  not  always  correct  in  her  callfi, 
in  this  disturbed  condition  of  the  bowels ;  the  patients  frequent- 
ly demanded  articles  which  proved  very  iigurious.  It  was  fre- 
quently the  case  that  the  sick  would  obtain  from  their  attendants 
cider,  beer,  &c.  These  weak  fermenting  drinks  always  proved 
injurious.  If  the  patients  wished  for  acidulated  beverage,  vine- 
gar diluted  with  water  was  grateful ;  it  allayed  thirst,  and  never 
proved  detrimental.  ,  '  .>     • 

"  Ardent  spirits,  in  the  first  stages  of  the  disease,  were  prohib- 
ited ;  and  when  given  by  the  over  otiicious  nurse,  invariably 
angmented  all  the  8ymi)toms  of  disease. 

'*  It  was  but  seldom  the  bark  [cinchona]  could  be  used  with 
:.<)fety  in  the  disease,  more  especially  in  powder;  as  it  occasion- 
ed severer  pains  in  the  bowels,  and  where  they  had  become  calm, 
induced  an  irregularity  which  was  obstinate,  and  with  difficulty 
removed. 

"  When  typhous  fever  made  its  appearance,  unconnected  with 
dysenteric  symptoms,  there  was  more  or  less  simple  diarrhcea. 
At  the  first  attack,  the  patient  complained  of  pain  in  the  head 
and  small  of  the  back,  nausea  at  the  stomach,  drowsiness,  bitter 
taste  in  the  mouth,  the  tongue  covered  with  a  white  fur  on  its 


lUti 


^1 


:jf«i.i 


T?WH 


,1    i 


Ilii! 


'/T^ 


\m\ 


Blf 


!! 


:    ; 


151 


MEDICAL  SK£TUUE6. 


Torepart,  and  a  dark  brown  colour  towards  its  base.  The  patient 
did  not  often  complain  of  rigors  passing  over  himself.  If,  how- 
ever, rigors  occurred,  more  or  less  inflammation  of  some  of  the 
viscera  generally  accompanied  the  disease ;  and  as  it  progressed, 
became  more  violent,  with  small  frequent  pulse,  disordered  head, 
cold  extremities,  sordes  on  the  teeth,  delirium,  stupor,  subsultus 
tendinum,  and  involuntary  discharges  of  both  fieces  and  urine. 
With  these  last  symptoms  the  fatal  scene  was  closed. 

**  The  treatment  in  the  first  stage  of  typhus  was  commenced 
by  an  emetic  of  fifteen  graiiis  of  ipecacuanha,  with  two  grains  of 
tartrite  of  antimony.  This  not  only  operated  as  an  emetic,  but 
as  a  cathartic.  If  the  latter  did  not  follow,  and  the  strength  of 
the  patient  permitted,  the  employment  of  a  cathartic,  neutral 
iaits,  or  clium  ricini  was  administered.  These  remedies  com- 
monly relieved,  in  some  measure,  the  pain  in  the  head,  and  the 
patient  appeared  better.  After  which  were  prescribed  sal  nitri 
and  tart,  antim.  in  small  and  repeated  doses  ;  and  if  the  head 
continued  to  be  aifected,  a  blister  on  the  nape  of  (he  neck.  If 
the  eKtremities  were  cold,  and  a  preternatural  heat  of  the  chest 
and  head  existed,  warm  flannels  were  applied  to  the  former,  and 
cold  vinegar  and  water  were  sponged  over  the  latter  parts.  A 
•diaphoretic,  composed  of  one  drachn*  jf  carbonate  of  potash, 
iialfft  pint  of  vinegar,  with  the  same  quantity  of  water,  was  di- 
rected, of  which  a  table  spoonful  was  given  every  two  hours. 
But  no  medicine  seemed  to  answer  as  well  as  the  prescription 
in  dysentery,  when  fever  was  combined  with  it;  viz.  nitras  po- 
iassa;  5  i*  ^^rt.  antim.  gr.  iii.  gum  opium  gr.  vi.  submuriate  of 
mercury  gr.  viii ;  these  were  combined  and  divided  into  tea 
powders,  of  which  one  was  given  every  three  hours. 
*•  The  above  prescriptions,  pursued  two  or  three  days,  changed 
the  appearance  of  the  tongue  from  a  dry  brown  colour  to  a  moist, 
and  of  a  more  natural  appearance. 

"  Some  were  admitted  into  the  hospital  so  much  reduced  un- 
tler  the  above  described  form  of  the  disease,  that  the  above  prac- 
tice could  not  be  pursued.  In  these  low  cases  the  emetic  and 
cathartic  were  inadmissible  ;  the  patients  were  supported  with 
weak  toddy,  making   use  of  the  last  mentioned  prescriptionst 


CAMPAIGN  OF  1814. 


157 


In  tlie  latter  stagfs  of  typhus,  the  patients  were  supported  by 
a  soft  nutritive  diet;  in  Bome  cases  blisters  were  applied  to  the 
wrist,  and  sinapisms  to  tlie  feet.  The  patients  were  ordered  a 
liberal  use  of  diluted  sj»irits,  with  a  decoction  of  the  serpentaria. 

*'  In  some  cases,  the  patients  were  disturbed  with  frightful 
dreams ;  in  which  o|)ium  did  not  succeed  to  procure  sleej),  but 
in  which  emlirocatlons  of  volatile  spirits  upon  the  head  had  the 
desirable  effect.  Where  diarrhoea  continued  after  abatement  of 
fever,  Dover's  powders  were  a<Uninistered  irt*  small  and  repeated 
doses,  and  where  it  was  not  checked  by  the  Jast  medicine,  more 
powerful  astringents  were  employed,  as  gum  kino,  ih  Tb  and 
opium. 

"In  many  cases  the  parotid  glands  became  enlarged  and  sup- 
purated ;  where  these  occurred  the  patients  uniformly  recovered. 

"  In  those  cases  where  pain  in  the  chest  was  an  accomj)any- 

ing  symptom  of  disease,  attended  with  cough,  a  blister  over  the 

pained  part,  and  cam[)horated  tine,  of  opium,  with  antimonial 

wine,  given  every  four  or  five  hours,  removed  the  local  affec- 

•  tion.  • 

*'  Success  generally  followed  the  above  course  of  practice. 
But  it  required  the  utmost  caution  to  prevent  relapses,  among  a 
large  body  of  men  habitually  irregular.  Exposures  to  cold,  an 
intemperate  use  of  liquors,  and  a  hard  indigestible  diet,  with 
which  the  convalescents  would  indulge  themselves,  frequently 
brought  on  relapses  which  often  proved  fatal. 

"  Diarrhffia  was  the  third  form  of  disease  that  called  our  atten- 
tion at  Burlington  hospital.  Even  where  the  men  had  no  fever, 
diarrhrea  supervened  in  almost  every  case  of  disease  in  the 
hospital,  or  previous  to  their  admittance.  One  fourth  of  the  sick 
labored  under  simple  diarrhoea,  and  many  under  its  most  obstin- 
ate chronic  slate.  Some  had  previously  been  so  much  reduced, 
no  medicine  seemed  to  have  any  permanent  effect  upop  them ; 
the  most  potent  astringents,  sudoiifics,  and  opiates  were  admin- 
istered in  vain.  These  unceasing  evacuations  continued  to  re- 
duce the  patients  until  death  closed  the  scene.  In  one  case,  the 
•efforts  were  so  strong  as  to  mime  an  umbilical  rupture  while  ou 
his  stool ;  in  two  instaaces,  inguinal  hernias  became  scrotal,  by 
21 


1 


ill 


i!i1! 


T58 


MEDICAL  SKETCHES. 


if' 


efforts  to  evaluate  the  contents  of  the  bowels.  Those  predis* 
posed  to  hemorrhoidal  affections  had  a  confirmed  state  of  this 
disease  induced  by  a  constant  irritation.  The  chronic  form  was 
accompanied  with  a  loss  of  appetite,  and  gre'it  debility.  As  di- 
arrhoeas commenced  while  men  were  exposed  in  the  field  to 
their  causes,  a  long  time ;  an  habitual  disease  was  induced  which 
continued  after  the  primary  causes  were  removed. 

"  In  the  more  recent  cases,  a  mild  cathartic  was  administer- 
ed ;  after  which,  small  and  repeated  doses  of  Dover's  powder,  ev- 
ery few  hours ;  also,  tepid  drinks  and  soft  nutriment.  The  bo- 
dy was  kept  warm  by  flannel  shirts.  Diluted  brandy  was  di- 
rected as  a  warm  stimulus  to  the  stomach  and  bowels.  In  cases 
where  the  disease  had  been  of  long  continuance,  excepting  opl- 
imi,  diluted  brandy  was  the  chief  medicine  depended  upon  as  a 
stimulus ;  the  patient  also  was  confined  in  bed  between  blankets. 
In  cases  where  there  was  a  loss  of  appetite  or  nausea,  a  blister 
applied  on  the  epigastric  region,  seldom  failed  to  remove  the 
sickness,  and  eventually  of  restoring  some  appetite.  To  check 
profuse  evacuations,  the  most  powerful  astringents  were  employ- 
ed, viz.  gum  kino  and  alum  in  combination ;  to  these  were  ad- 
ded stimulants,  as  ardent  spirits;  opium;  laudanum  and  aqua 
ammonia  in  equal  parts ;  a  tea-spoonful  of  this  mixture  was  fre- 
quently administered,  as  the  case  required. 

"  The  following  bitter  stimulus,  after  evacuations  ceased,  was 
found  beneficial. 

"  R.  Rad.  gentian.  5  ss. 
Cort.  Aurant.  ^  ss. 
Serp.  Virgin.  3  "i* 
Canella  alba    5  i-  contus. 

"  After  these  had  been  infusod  in  one  quart  of  brandy  a  num- 
ber of  days,  a  table-spoonful  was  administered  three  or  four  times 
in  a  day. 

"  Chalk  julap  was  frequently  employed  without  any  benefit. 
An  injection  of  the  iuftision  of  galls  had  often  a  good  effect,  when 
every  other  remedy  disappointed  us ;  and  in  the  latter  stages  of 
disease,  when  tlir  patient's  strength  was  much  reduced,  we  have 
employed  it  combined  with  laudanum,  with  great  advantage. 


CAMPAIGN  OP  18U. 


>5a 


'<  We  fbund  it  necessary  to  confine  the  patients  labouring  un« 
der  diarrhoea,  to  warm  drink»,  soft  diet,  and  in  bed.  The  prep> 
arations  of  the  farinacea  and  milk  were  only  allowed  them. 
While  mentioning  milk,  we,  from  experience,  found  that  no  ar- 
ticle of  diet  was  superiour,  not  only  in  this,  but  other  diseases 
to  which  soldierii  were  subjected.  The  sick  soldier  acce|)ted  of 
this,  in  which  a  little  oat-meal  was  boiled  a  few  minutes,  when 
he  refused  every  other  kind  of  nutriment  offered.  This  alone 
constituted  the  nourishment  of  these  sick  patients  several  days ; 
and  we  are  persuaded  was,  in  many  instances,  conducive  to  their 
restoration  to  health. 

"  In  some  instances,  jzreat  thirst  attended  this  disease,  when 
no  quantities  of  mild  drinks  seemed  to  abate  the  intolerant  sen-r 
sation  ;  nothing  contributed  to  give  immediate  relief,  so  soon  aa 
spirits  and  water;  but  if  spirits  were  largely  diluted,  this  bever- 
age did  not  have  the  desired  effect."  This  was  the  silisfrigida 
of  Darwin. 

"  In  curing  this  disease,  or  checking  the  evacuations  when 
they  had  become  chronic,  great  caution  was  necessary.  Drop-' 
sical  swellings,  anasarca,  ascites,  supervened  on  those,  where  the 
discharges  were  suddenly  and  permanently  checked  by  astriur 
gents.  This  was  more  particularly  the  case,  where  the  patient 
was  advanced  in  years.  Whenever  these  occurred,  drastic  pur- 
ges, by  producing  a  recurrence  of  the  former  disease,  reduced 
the  swellings ;  after  which,  it  was  found  most  necessary  to  check 
diarrhoea  in  a  gradual  manner,  by  small  doses  of  rhubarb ;  and 
at  the  same  time,  the  following  tonic  preparation : — 
"  R.  Sul[)h.  martis  ^  ss. 

Carb.  pottas.  ^  i. 

Tine,  ealom.  f^  i. 

Tine.  laud.  gt.  Ixxx.  roisce. 
"  A  table  spoonful  of  the  above  composition  was  given  four 
times  in  a  day ;  and  occasionally,  diluted  brandy.  When  the 
legs  and  thighs  were  much  enlarged,  as  soon  as  they  began  to 
subside,  were  rubbed  with  equal  parts  of  spirits  and  water ;  when 
a  spiral  bandage  was  neatly  applied  upon  the  limb,  beginning  at 
the  toes  and  extending  it  to  the  groin.  This  application  wa»  ill 
all  cases  found  highly  beneficial." 


5r 


1 


160 


MEDICAL  SKETCHES. 


m 


A  Report  of  Hospital  Surfrcon  liOVELi.,  of  the  state  of  dis- 
eases among  the  troojts  on  the  Niagara  frontier^  during  Ihc 
campaign  of  1814,  is  as  follows : — 

*'  The  troops  engaged  in  this  l»ri!liant  campaign  on  tlie  Nia- 
gara, began  to  collect  there  about  the  beginning  of  April,  under 
the  command  of  General  Scott.  They  were  encamped  on  an 
eminence  norUi  of  Buffalo  villafT;e,  having  a  thick  wood  in  front, 
which  extended  to  the  barik  of  the  river,  the  ground  being  in 
part  swampy  and  wet.  On  the  left  of  the  encampment  was  a 
large  marsh,  extending  from  the  high  ground  to  die  margin  of 
the  lake.  The  winds  from  the  lake,  at  this  season,  were  remark- 
ably cold  and  chilling ;  resembling,  in  sensation,  e  actly  the 
east  winds  which  prevail  on  the  Atlantic  during  the  spring;  and 
had  an  astonishing  effect  upon  vegetation.  The  trees  around 
the  encampment  having  the  appearance  of  winter,  while  those 
five  or  six  miles  from  the  lake  shore,  were  covered  with  verdure. 
Notwithstanding  this,  the  troops  were  remarkably  healthy ;  only 
one  or  two  deaths  occurring  before  they  crossed  the  Niagara,  on 
the  3d  of  July — even  the  demon  diarrhoea  ap|)eared  to  have  been 
exorcised  by  the  mystical  power  of  strict  discipline  and  rigid  po- 
lice. 

"  In  June  a  number  of  new  recruits  joined  the  army ;  and  sev- 
eral were  collected  from  the  various  hospitals ;  the  latter  princi- 
pally composed  of  the  miserable  refuse  of  society,  who  never 
had  energy  enough  to  demonstrate  that  they  lived,  and  scarcely 
enough  to  prove  that  they  existed.  With  these  last  detacli- 
menls,  arrived  our  old  acquaintances,  which  however  were  easily 
checked;  and  much  seldomer  returned,  than  in  any  former  cam- 
paign. This  was  undoubtedly  to  be  attributed  to  the  improve- 
ment in  police. 

"  During  June,  the  weather  became  very  warm,  and  a  thick 
fog  arose  from  the  marsh  and  woods  at  sunset,  and  remained  for 
some  time  after  sunrise.  During  this  month,  intermittent  fever, 
acute  rheumatism,  and  typhous  fever  were  the  prevailing  com- 
plaints. The  intermittent'3  were  very  irregular  and  obstinate. 
Arsenic,  which  was  the  sovereign  remedy  the  last  year,  on  this 
frontier,  had  now  very  little  effect  j  while  the  bark,  which  theu 


CAMPAIGN  OF  1814. 


lOfc 


failed,  was  now  gpnerally  Buccessrwl.  Some  obstinate  cnsos,  in 
which  every  thin  Ise  had  failed,  were  cured  by  the  sulphate  of 
copper.  Three  patients,  Who  had  tried  moat  of  the  remedies 
with  which  we  were  supplied,  without  effect,  cured  themselves 
at  once,  by  taking  a  pint  of  brandy  undiluted,  in  which  was  mix- 
ed a  large  quantity  of  ground  black  pepper,  on  the  accession  of 
the  cold  stage.  This  was  not  followed  by  inebriation  nor  any 
appearance  of  undue  excitement.  It  led  me  to  use  oi»iiim  in 
much  larger  quantities  than  I  had  been  accustomed.  It  was  be- 
gun with  four  or  live  grains  at  a  dose,  and  increased  until  some 
stimulating  effects  were  produced,  or  the  disease  cured.  The 
success  of  this  prescri|)tion  was  very  great  during  the  whole  sea- 
son. In  fine,  of  the  remedies  used  this  season,  emetics  had  but 
little  effect,  even  at  first;  and  the  mineral  solution  scarcely 
any — bark  succeeded  in  the  majority  of  cases ;  and  opium  very 
seldom  failed.  A  few  obstinate  cases  were  checked  for  several 
periods,  by  the  application  of  tourniquets  to  one  leg  and  one 
arm;  the  disease  however  recurred;  the  tourniquets  then  had 
no  effect;  but  remedies,  which  had  before  failed,  now  succeed- 
ed, after  the  interruption  thus  produced  in  the  morbid  associa- 
tions. 

"  Rheumatism,  during  the  whole  war,  generally  put  on  a  re- 
mitting form;  this  was  particularly  obvious  whenever  intermit- 
tent fever  prevailed,  and  more  especially  this  season.  Bleeding 
was  but  seldom  necessary ;  after  a  brisk  cathartic,  bark  was  giv- 
en in  the  quantity  of  from  4  to  8  drachms  during  the  remission, 
and  a  large  dose  of  opium  on  the  accession  of  the  fever;  and  al- 
ways in  sufficient  quantity  to  relieve  the  pain.  This  treatment 
was  very  generally  successful.  I  was  induced  to  try  it,  in  many 
cases,  where  the  remissions  were  very  slight,  and  generally  ef- 
fected a  cure.  In  these,  however,  bleeding  or  purging  were 
premised,  which  produced  more  perfect  remissions.  In  short,  I 
considered  the  bark  and  opium  the  remedies  for  rheumatism,  par- 
ticularly when  intermittents  prevailed,  and  for  the  most  part 
succeeded.  ■ 

"  Many  of  the  cases  of  typhus,  about  the  end  of  May,  were 
remarkably  severe.    The  most  prominent  symptoms  were  great 


t 


m 


n    I 


162 


MEDICAL  SKETCHES. 


'■i 


m'^ 


prostration  of  strength,  and  delirium ;  of  tlie  species  not  attend* 
ed  with  symptoms  of  great  arterial  action  in  the  head,  local  ap- 
plications as  usual  having  no  effect  upon  it.  Symptoms  of  re- 
covery  were  not  ol)8erved  in  these  cases,  until  the  end  of  the 
third  week.  The  treatment  adopted  was  strictly  that  of  Fo^ 
dyce,  and  recovery  took  place  in  every  instance. 

"  On  the  first  of  August,  a  general  hospital  was  established  at 
Williamsville,  eleven  miles  eust  from  Buffalo.  The  number  of 
sick,  during  the  remainder  of  the  season,  a:t  this  place,  varied 
from  3  to  400  ;  the  number  of  wounded  being  somewhat  greater. 

"  The  troops  suffered  much  during  the  siege  of  Fort  Erie ;; 
and  soon  after  it  was  raised,  the  rainy  season  commenced^ 
Dysentery  and  diarrhoea  were  the  principal  diseases.  I  be- 
came fully  convinced  after  a  fair  trial  of  every  medicine  to  be 
obtained  at  this  place,  of  the  decided  advantage  of  ipecacuanha 
in  various  forms  and  doses,  to  any  other  remedy.  The  remark- 
able effects  of  lliis  medicine,  which  Fordyce  considers  as  acting 
specificail}'  in  typhus  fever,  led  to  the  conclusion,  that  the  febrile 
symloms  attending  the  latter  stages  of  diarrhoea  were  in  fact  a 
true  typhus,  supervening  upon  the  former  complHint.  Hasty  in 
his  treatise  on  dysentery,  he  speaks  of  several  complaints,  which 
are  often  combined  with  typhus  fever ;  and  are  then  generally 
contagious ;  and  1  had  observed  that  the  nurses  of  the  wards, 
where  diarrhoea  prevailed,  were  often  attacked  with  typhus,  ac- 
oompanied  with  diarrhoea,  or  a  great  tendency  to  it.  Decided 
benefit  had  often  been  observed  from  small  doses  of  ipecacuanha, 
with  mucilaginous  drinks,  in  an  irritable  state  of  the  stomach 
and  bowels,  which  appeared  to  be  owing  to  a  degree  of  inflamma- 
tion extending  through  the  mucus  coats;  and  not  attended  with 
febrile  symptoms  ;  and  it  is  probable  that  the  good  effects  of  the 
remedy,  in  the  cases  now  referred  to,  were  in  some  measure  to  be 
attributed  to  this  mode  of  operation.  Intermittent  fevers  and 
rheumatism  prevailed  during  the  whole  season,  and  varied  but 
little  from  the  cases  in  May  and  June.  The  cases  of  typhus  a- 
mong  the  regular  troops  were  generally  mild. 

"  AlHJut  the  end  of  September,  a  large  detachment  of  militia 
crossed  the  Niagara,  under  General  P.  B.  FgftxER.     Diarrhoea; 


CAMPAIGN  OP  1814. 


163 


typhus  ftnd  idiopathic  dysentery  very  soon  made  their  appear- 
ance among  them ;  the  two  latter  were  extremely  severe.     As 
these  patients  were  not  sent  to  the  general  hospital,  until  they 
had  been  sick  for  some  time,  I  saw  only  the  latter  stages  ot  these 
complaints.     The  dysentery  was  at  this  period  very  obstinate; 
the  bloody  discharges  and  tenesmus  incessant,  and  the  prostra- 
tion of  strength  as  usual  most  dangerous.     In  this  state,  relief 
was  very  generally  obtained  from  injections  of  a  decoction  of  ip- 
ecacuanha, sometimes  combined  with  laudanum ;  at  others,  the 
irritability  was  first  reduced  by  an  injection  of  laudanum  alone. 
The  decoction  was  often  rejected  immediately ;  it  had  however 
some  efiect  even  then,  so  that  by  repeating  it  several  tim<3s,  it 
would  finally  remain,  and  give  relief.     Blisters  to  the  abdomen 
often  had  a  very  good  effect ;  but  no  application  to  the  part  ap- 
peared generally  to  prove  so  beneficial,  as  a  poultice  of  slippcry- 
elm-bark  to  the  whole  abdomen,  often  repeated.     It  relieved  the 
tenesmus,  and  produced  a  gentle  diaphoresis,  which  was  promot- 
ed by  warm  mucilaginous  drinks,  a  mixture  of  tine.  opii.  and  tine, 
ipecac.     This  was  the  only  treatment  found  beneficial  in  the 
latter  stages  of  this  complaint,  and  it  very  generally  succeeded. 
Typhus,  among  the  militia,  was  very  severe.     Patients  were 
seldom  sent  to  the  general  hospital,  until  the  third  week  of  the 
fever ;  and  the  treatment  had  been  as  different,  as  the  whims  of 
the  attending  surgeons.     The  most  usual  practice,  however,  a- 
niong  them,  was  to  blister  the  patient  almost  from  the  crown  of 
his  bead  to  the  soles  of  his  feet ;  so  that  the  chief  difficulty  was 
to  remove  the  irritative  fever  induced  by  this  empirical,  slovenly 
practice.     In  some,  calomel  had  been  employed,  but  generally 
without  any  obvious  effect,  except  increasing  the  danger  of  the 
patient.     At  this  stage  of  the  complaint,  and  under  these  circum.- 
stances,  no  general  method  of  treatment  could  be  adopted,  ex- 
cept remedying  the  mischief  which  had  been  done.     The  cure 
was  principally  attempted  by  removing  every  cause  of  irritation, 
as  appeared  most  urgent,  and  trusting  to  nursing  and  nourish- 
ment.    IJnder  this  plan  many  appeared  to  be  in  a  fair  way  of  re- 
covery ;  but  in  the  course  of  the  4th  week,  a  small  circumscrib- 
ed spot  of  iaflammation  shewed  itself  in  the  face,  generally,  near 


''Hi 


1  t 


r 


i-   o- 


164 


MEDICAL  SKETCHES. 


the  angle  of  (lie  mouth.  In  a  Tew  days,  the  whole  side  oT  tlie 
faee  swelled;  this  tumour  was  hard  ami  pale,  resemliliiiji;  the 
colour  of  a  while  swelling  of  the  joints.  It  was  not  in  the  seat 
of  the  parotid  ^land,  hut  anterior  to  the  branch  or  the  lower  jaw, 
and  was  attended  with  a  most  profuse  and  fttiil  salivation,  ap- 
parently from  irritation  communicated  along  the  salivary  duct, 
as  the  liver  and  gall-bladder  are  excited  by  the  chyme.  In  a 
few  days  more,  the  red  spot  began  to  assume  a  livid  afipearance, 
and  symptoms  of  incipient  mortification.  In  a  short  time,  the 
nioulh  was  liternlly  extended  from  ear  to  ear,  exposing  the  back- 
most grinders  on  holh  sides.  All  the  remedies  usually  em|)loy- 
ed  in  this  species  of  disease,  were  em|»loyed  without  visible  ben- 
efit. The  only  article  which  appeared  to  produce  any  good  ef^ 
feet  was  charcoal,  which,  however,  seemed  only  to  prolong  the 
sufferings  of  the  patients.  Three  attacked  with  this  affeclioa 
had  severally  so  far  recovered,  as  to  have  a  good  appetite,  and 
sit  up  a  great  part  of  the  day.  Their  strength  and  appetite  held 
out  surprisingly  after  mortification  had  taken  place.  I  have 
since  seen  two  instances  among  citizens ;  one  in  Boston,  on  a 
young  boy.  He  had  so  far  recovered  as  to  sit  up,  he  took  nour- 
ishment with  a  good  appetite,  and  every  symptom  of  fever  had 
disa(i|teared ;  when  about  the  middle  of  the  fourth  week,  the 
swelling,  salivation  and  mortification  took  place,  and  shortly 
sunk.  It  should  be  added,  that  in  the  majority  of  these  cases, 
I  jt  a  particle  of  mercury  had  been  used  in  any  form." 


Ji 


The  follmving  cases  of  a  siinilar  disease  as  the  last  noticed  by 
Doctor  LovELL,  were  reported  In/  Doctor  Purcell,  with  his 
observations,  at  Burlington  Hospital,  in  the  Autumn  of  1814. 

CASE    FIRST. 

"  Thomas  Burns,  a  soldier,  16th  infantry,  was  admitted  into 
the  hospital  7th  September,  with  an  enlargement  of  the  parotid, 
and  submaxillary  glands,  and  soreness  of  the  tonsils,  accompan- 
ied with  a  large  flow  of  saliva.  The  tumefaction  extended  from 
the  glands  down  the  neck.  The  tumefied  parts  were  so  great 
and  tender,  that  the  mouth  could  not  be  opened  sufficiently  wide, 
lo  admit  of  the  inspection  of  the  fauces.    No  food  could  br 


CAMPAIGN  OF  ir.M. 


165 


rrccived  cxrrpl  in  a  li(|iii(1  form.  DIsc.isrs,  at  Hiis  llmo,  were. 
tlisposrd  to  niti  iiilo  1}  phiis.  This  circumstance,  and  csprcially 
as  no  foviMS  acconii)an.j(l  tlie  complain!,  determined  ns  to  dlg- 
pnisc  willi  c'vnciiationn  ;  and,  vicwini;  it  as  a  local  disease,  not 
dejfcndent,  and  unconnected  with  a  {general  alTection,  to  depend 
on  the  empl(»ymcnt  of  local  applications. 

"  The  tumid  parts  were  embrocated  uilli  volatilt;  liniment  ev- 
ery four  or  five  hours  ;  after  whi<;h  a  flannel  !)andai:5C  was  applied 
over  tlie  jaws.  By  tills  manat^ement,  the  swellings  in  a  few 
d;iy8  were  reduced,  while  the  profuse  siilivation  and  soreness  of 
(lie  fauces  continued.  At  first  it  was  lielicved.  that  the  com- 
plaint was  |)roduced  by  mercury ;  but  having;  been  ./ssured  by 
the  patient,  he  had  not  taken  any  medicine  along  time  |)reviou« 
to  his  admittance  into  the  hospital,  and  this  assurance  liavins; 
been  imaccompanied  with  that  peculiar  smell  of  his  breath,  which 
denotes  mercurial  excitement  in  the  system,  convinced  us  that 
our  first  conjecture  was  incorrect. 

"  A  fiargle  of  borax  dissolved  in  water  was  directed,  and  the 
liniment  continued.  These  applications  were  employed  ten  or 
fifteen  days,  but  w  ith  very  little  benefit.  By  this  time  the  sore- 
ness in  the  glands  and  tumefiiclion  were  so  much  reduced,  as  to 
admit  the  opening;  of  the  mouth,  so  as  to  inspect  the  fauces.  The 
first  appearance  which  attracted  the  attention  was  a  lar^c  ulcer, 
commencing  half  an  inch  from  the  lip,  on  the  left  side  of  the 
iongue,  and  extending  half  way  to  its  base.  U[)on  pressing  the 
tongue  down  with  a'spatula,  ulcers  appeared  on  each  side  of  the 
cheek,  and  over  the  anterior  surfiice  of  the  tonsils,  the  dcntes 
molares  were  incrusted  wilh  a  hard  substance  of  some  thickness. 
The  breath  was  intolerably  fetid.  The  surface  of  these  ulcers 
appeared  white,  and  adhered  to  the  sound  parts  as  if  they  had 
been  a  component  part,  but  now  an  inorganic  substance,  which 
was  with  dilTiculty  removed. 

*'  At  this  time  the  patient  was  directed  to  the  use  of  a  gargle 
composed  of  sulphate  of  zinc,  vinegar,  and  w  ater,  and  to  contin^ 
ue  the  volatile  liniment.  Having  continued  the  above  applica- 
tions twelve  days,  and  no  benefit  having  been  experienced. 
«  gargle  of  alum  and  kino  was  substituted.  No  better  effrcfH 
22 


■.il  i 


il'K 


lit 


111 


!  ! 


ii 


106 


MEDICAL  SKETCtlEri. 


were  cxperieuccd  frum  ilie  last  ineiiicinc.  A  solution  of  mtiriai 
liydrarriiyri,  one  grain  to  an  ounce  of  water,  was  next  prescrilicd 
as  n  gargle  to  he  used  several  times  in  a  day.  After  continuini^ 
the  Inst  medicine  three  weeks,  w  itiiout  any  henetit,  recourse  wag 
had  (o  Fowler's  mineral  solution,  five  drops  of  which  were  di- 
rected in  half  a  gill  of  water,  three  times  in  twenty-four  hourH. 
There  was  an  apfiarent  change  for  the  better  in  the  ulcer,  on  the 
second  day.  The  inorganic  substance  had  detached  itself;  the 
condition  of  the  ulcers  appeared  healthy  and  the  breath  less  fe- 
tid. By  the  continued  employment  uf  the  last  prescription,  the 
sores  in  a  few  days  were  healed. 

"  It  should  be  observetl,  that  the  pn.ient  laboured  under  no 
other  disease  at  the  time  he  was  admitted  into  the  hospital,  l)ut 
was  muscular  and  strong :  his  complaints  had  been  of  three 
raonllis  duration,  previous  to  the  use  of  the  arsenic  preparation. 
It  was  employed  only  six  days  until  every  vestige  of  the  disease 
disappeared." 


!• 

; 

ii 

r 

II 

-* 

1 

;i 

*  t 

1! 

CASE  SECOND. 

The  follow  ing  symptoms  of  a  second  case  were  given  by  one 
of  the  surgeons,  who  attended  in  the  early  stage  of  the  disease. 
"  The  patient  was  seized  with  pain  a  little  above  the  inferior 
portion  of  the  nose  which  extended  to  the  adjacent  parts.  It 
was  light  at  first,  but  in  eight  or  ten  hours  became  very  severe. 
In  its  incipient  stage,  an  efflorescence  appeared,  which  gradually 
assumed  a  deeper  colour,  and  was  accompanied  with  a  little  tum- 
efaction, which  enlarged  until  the  parts  became  disorganized. 
This  process  was  rapidly  performed  in  three  days. 

"  The  ulcer  was  formed  when  I  first  saw  the  case;  (says  Doc- 
tor Purcelij)  then  an  ichorous  corrodin  ;  matter  issued  from  the 
sore,  vvliich  destroyed  the  surrounding  teguments,  and  the  ossa 
naris  became  carious  in  a  few  days.  The  disorganized  muscles 
assumed  a  black  and  flabby  appearance  ;  the  edges  of  the  ulcer 
w  ere  indented,  and  the  circumjacent  parts  slightly  swelled.  The 
disease  progressed  until  it  reached  the  eye,  when  that  organ  be 
came  much  enlarged,  so  that  the  ball  protrud(jd  from  its  socket. 
The  pain,  at  this  stage  of  the  disease,  was  insupportable. 


fill 


•^W»»^W^ 


CAMPAIGN  OF  1814. 


101 


'•  Thfi  nppellte  was  not  impaired  iinlil  the  eye  was  afTectcd 
A  ileliriiim   then  supprvened,  the  patient  liecnme   ravinj;  when 
the  appetite  failed,  and  death  soon  closed  tlie  scene. 

"  Two  other  soldiers  were  attacked  after  a  similar  manner. 
Upon  hoth,  the  disease  commenced  and  pros^ressed  with  all  the 
dreadful  appearances,  as  described  in  ttie  first  case,  and  terminat- 
ed fatally  in  a  few  days. 

*'  The  several  stages  of  the  disease  followed  each  other  in  rap- 
id succession.  The  practice  however  cannot  be  particularly 
detailed.  TJie  general  remedies,  in  the  first  stage,  prescrib- 
ed, were  to  counteract  inflammation ;  after  the  ulners  were  form- 
ed, a  carrot  poultice  was  applied ;  all  without  any  benefit." 


( 


CASE    TIITRD. 

"  A  sohlier  was  attacked  soon  after  the  above  fatal  cases,  with 
symptoms  so  similar,  that  an  unfavourable  termination  was  prog^ 
nosticated.  It  was  suggested  to  the  attending  surgeon,  to  ad- 
minister the  Fowler's  solution.  The  plan  was  adopted,  as  in  the 
first  recited  case.  To  our  great  satisfaction  every  unpleasant 
symptom  disappeared,  and  the  man  was  reported  for  duty  with- 
in one  week. 

"  Quere,  did  the  arsenic,  in  the  above  cases,  act  as  a  stimulus 
and  tonic  ?  The  three  last  patients  had  been  reduced  by  previ- 
ous diseases.  This  circumstance  induces  a  belief,  that  as  the 
swelling  was  not  truly  phlegmonous,  these  were  diseases  of  de- 
bility ;  and  that,  in  the  fortunate  cases,  the  cures  were  eflected 
by  the  stimulant  and  tonic  powers  of  arsenic." 

DISSECTIONS. 

"  Upon  dissection,  the  diseased  parts  through  their  whole  ex- 
tent, were  found  completely  disorganized.  The  nasal  bones, 
and  molar  teeth  on  the  side  affected,  were  either  carious  or  en- 
tirely destroyed ;  the  periosteum  of  the  adjoining  bones  was  re- 
njoved,  even  where  the  superincumbent  teguments  appeared 
sound;  between  which,  and  the  bone,  of  a  dark  colouf,  was  lod^ 
ged  a  dark  ichorous  matter." 


.i 


i< 


il#|!'ll 


^ 


ICC 


MliUIt'AL  SKETCIIE?^. 


:r, 


liAKi:  CIIAMI'LAIX,  AM»  UJM'lt  ST.  LAWUK.N tf:. 

THOMTERS. 

lii'RLiNRToN  is  oilualfd  oil  Ihi^  onsl.  sitit*  of  liUke  ClKiiiiplniii, 
distiiiil  from  While  Hall  70  miles  nurtii;  tlic  first  village  lice 
164  milca  north  from  AllKiiiy. 

From  a  wildt'rnrss,  (hi!)  most  hcniiliful  vilhi,i!:«  hue,  in  (wen- 
tyfive  years,  become  a  phice  (»f  eoiisidcrjiMc  importance.  From 
llie  lake  shore  it  rises  hy  uii  easy  and  regular  ascent  one  mile, 
to  the  summit  of  the  lukc-hill.  Upon  the  extreme  height  of 
land  bordering  (he  lake,  is  erected  u  handsome  eollege  edifice, 
Avhich  overlooks  (he  vi!la<;(!  Ixlow,  rej^iilarly  built  on  strreli* 
which  intersect  each  other  at  ri;^lit  anules.  From  this  eminence 
tlie  prospect  is  extensive  und  picliire3(|iie,  possessing  an  exten- 
sive view  of  the  lake,  in  whicli,  are  in  sight  some  small  islanib. 
Tliid  prospect  is  terminateil  i)y  the  mountains,  which  range  oii 
(lie  west  border  of  (he  lake,  from  south  to  north,  the  whole  ex- 
tent of  tlie  viaible  liovi/.on.  On  the  east,  (he  view  is  interrupted 
Ly  forests,  but  which  will  be  more  extensive  as  the  country  im- 
proves. Ueyond  tlie  iiiterveniMi;'  woodlands,  rise  appiring  ridg(  r 
of  mountains,  ^,hich  divide  the  state  of  Vermont  from  ftouth  Id 
north  its  whole  extent,  known  l)y  the  nameof  (Jreen  MounlaiiiN 
from  which  (he  utate  derives  \l^  n;ime.  From  the  baacs  of  ilx 
mountains  to  the  lake,  which  i.s  the  west  boundary  of  Verinoiif 
the  distance  is  twenty  miles.  This  tract  is  under  good  cultiva- 
tion; the  B(til  rich,  anil  very  productive  in  grass,  every  sjiecic? 
of  grain,  and  fruits.  The  whole  of  this  district  is  in  an  improv 
ing  state.  From  the  tioulhern  extremity  to  Canada  line,  are 
seen  farms  in  a  good  »tale  of  cultivation,  and  at  distances  of  six 
and  ten  mileii  Croni  each  other,  pi'  -^ant  village?;  interspersed 
with  ycats  built  in  the  modern  style  of  architecture,  wliich  iu' 
dicatcis  Ihul  the  [losscssurs  arc  v.cullliy  aud  ai!!i:eat. 


CAMPAIGN  OF  1811. 


lod 


Tli^  MilUary  Uosititul  iit  Hiirlin};;toii  in  ^ituntcd  on  the  hi){h 
bank  of  Uu;  lako  fiiiorc,  olovnUnl  (>()  foct  abovo  itx  \vi)U>r»;  thu 
•uil  of  which  is  (;rnvi;l,  wliicli  iininediutcly  drinks  up  (ho  wnter 
as  soon  as  it  falls  in  rain ;  so  tli:it  during;  the  wet  seasons  o(  tlie 
year  Ihr  (ground  in  the  vicinily  of  the  ho«|dlat  is  free  from  nutd 
and  even  moisture.  The  Eiluation  of  (his  (losition  in  lieultiiy  ; 
much  iireferuhle  to  any  wliicli  I  saw  on  eitlier  the  northern  or 
westerti  rrnntiers. 

Pi.ATTBDiKoii  is  situatcd  on  a  bay  the  weet  side  of  Cliam- 
plain  fiakc,  iiO  miU's  nortii  of  its  southern  extremity.  It  is  U.'i 
miles  south  of  Montreal.  The  village,  handsomely  laid  out, 
forms  a  crescent  on  the  high  lake  bank.  The  country  in  its  vi- 
cinity is  level,  lint  rises  gradually  to  the  west,  some  distance; 
then  abruptly  to  lofty  mountains.  Thevilla;;e  is  intersected  by 
the  Haranac,  which  empties  into  the  bay  from  the  S.  W.  Its 
course  is,  for  two  or  Ihiee  miles,  nearly  parallel  with  the  lake 
shore,  from  half  to  one  mile  distant  from  it.  On  the  tongue  of 
land  comprised  between  the  lake  and  river,  are  the  United 
States'  fortificatior.a,  extending  from  the  lake  bank  to  (he  river; 
80  situated  that  they  reciprocally  defend  each  other's  llanks. 
This  post  is  three  fourths  of  a  mile  above  the  lower  bridge  over 
the  Saranac,  near  its  outlet,  and  one  mile  and  half  below  the 
npper  bridge.  The  forests  arc  cut  to  the  distance  of  one  mile 
south ;  beyond  which  to  Peru,  distant  nine  miles,  few  settle- 
ments  are  seen  on  t!ie  lake  shore ;  on  the  Saranac  none  short  of 
Union  village,  distant  six  miles.  General  Pikf/s  cantonment, 
during  the  winters  1312-13,  was  about  half  the  distance  betweeu 
the  fortifications  and  the  last  village.  The  woods  had  been  cut 
at  (his  place ;  on  this  account  this  point  was  selected  by  the 
British  army  to  cross  the  river.  After  it  had  gained  the  eastern 
bank,  and  entered  the  adjacent  forest,  it  was  attacked  by  the 
New- York  militia,  under  General  Mookrs,  who  retired  to  Un- 
ion village,  where  they  were  joined  by  the  Vermont  volunteers 
under  the  command  of  General  Strong,  when  the  action  be- 
came  warm. 

The  British  retired  and  recrossed  (he  Saranac  at  the  same 
point  they  first  forded  the  river. 


m 


>> 


v 


If; 


Ijltl 


11 


^  ' 


'   r 


* 


170 


MEDICAL  SKi'^TCHES. 


■'  II 


m 


■)i' 


1 

'-'■! 

%\ 

1 

! 

t 

^^ 

bA-^ 

ill: 

The  left  of  the  British  army  rested  on  Platlshurgh  hay,  oue 
mile  north  of  the  Saranac ;  its  ri<2;lit  v\  ing  extending  to  a  point 
on  tlie  Saranac  near  the  upper  bridge,  one  and  half  mile  above 
the  fortifications.  Between  these  two  extreme  points,  the  dis- 
tance is  three  miles.  Advanced  of  their  line,  the  British,  be- 
tween the  6th  and  11th,  erected  seven  batteries. 

The  village  of  Plattsl)urgh,  comprising  70  houses,  is  pleasant- 
ly situated  on  the  high  hank  of  the  lake.  It  is  a  place  of  con- 
•idcrahle  trade ;  mostly  in  lumber,  which  is  rafted  over  the  lake, 
and  down  the  Sorel  and  St.  Lawrence  to  Quebec.  The  courla 
for  the  county  are  held  here.  The  county-house  with  a  number 
of  private  dwellings  were  burnt  at  the  time  the  post  was  invest- 
ed by  Sir  George  Prevost. 

Tlie  soil  of  this  district  is  good  for  grazing,  but  inferior  to  that 
west  of  Utica.  Alter  leaving  the  settJ^mc  its  of  Plattaburgh,  tlie 
route  to  Malone,  distant  52  miles,  is  dreary,  through  forests  of 
hard  and  soft  woods  intermixed,  with  a  log  hut  once  in  four,  six 
and  eight  miles,  until  we  arrive  at  Chateaugay  four  corners, 
where  is  a  small  village  of  eight  or  ten  houses.  From  this  we 
pass  a  forest  and  few  settlements,  at  a  distance  of  twelve  miles, 
when  suddenly  opens  the  pleasant  village  of  Malone.  From 
this  to  French  Mills  is  a  distance  of  16  miles;  near  the  point 
where  the  43th  degree  of  north  latitude  intersects  the  river  St. 
Lawrence,  being  the  line  of  demarkation  between  the  United 
States  and  Canada.  Up  this  river' to  Sackett's  Harbour,  160 
miles,  are  thinly  scattered  vill^iges.  The  most  of  the  road  is 
through  a  wilderness.  The  villages  are  pleasant,  particularly 
Ogdensburgh,  ninety  miles  from  Malone,  and  70  N.  E.  from 
Sackett's  Harbour.  The  brigades  of  Generals  Chandler  and 
Pike  endured  a  severe  storm  of  snow  on  this  route  in  the  month 
of  March,  1813  ;  where  they  found  snow  three  feet  deep  on  an 
average,  until  they  arrived  in  tl.e  vicinity  of  Lake  Ontario. 
The  snow  never  falls  the  same  depth  on  the  holders  of  the 
large  lakes,  rwCi  ..welve  miles  back,  as  it  does  beyond  this  dis- 
fance. 

All  tho  mountainous  parts  of  New-England  and  state  of  New- 
York,  duijug  winter,  are  pregnant  with  storms  of  snow,  when. 


CAMPAIGN  OP  1814. 


171 


aL  the  same  lime  on  the  Atlantic  shores,  it  generally  rains. 
On  the  herders  of  the  great  lakes,  I  \vas  always  disappointed  in 
my  prognostications  of  weather  from  the  appearance  of  the  skj'. 
Even  the  first  settlers  acknowledged  their  ignorance,  being  unable 
to  predict  in  the  morning  what  the  weather  would  be,  or  in  the 
evening  what  the  morning  would  bring  forth.  At  Lewisto.vn 
on  the  Niagara,  storms  of  rain  and  snow  were  experienced,  with 
winds  from  every  quarter  of  the  compass.  On  the  Atlantic, 
storms  of  any  duration  are  from  the  E.  and  N.  E. 

On  the  29th  May,  1813,  the  enemy  seized  the  opportunity 
when  Sackett's  Harbour  was  left  almost  defenceless,  under  the 
Cf^mmand  of  Major  General  Brown,  with  300  United  States' 
troops  -ind  a  small  body  of  militia,  to  attack  the  post  with  all  his 
force  from  Kingston ;  but  after  he  made  good  his  landing,  and 
advanced  as  fur  as  the  barracks  near  the  harbour,  was  repulsed 
with  considerable  loss.  In  this  action  fell  Colonel  Backus  of 
the  army,  and  Colonel  Mii^ls  of  the  New- York  volunteers. 
This  first  action  in  which  General  Brown  was  engaged,  and 
which  terminf'ted  with  much  honor  to  the  small  detachment  of 
regulars  commanded  by  Major  Aspinwall,  after  the  death  of 
his  superior  olficers,  was  honourably  noticed  by  Government ; 
particularly  by  the  appointment  of  General  Brown,  then  of  the 
Militia,  to  the  r  nk  of  Brigadier  General  in  the  United  States' 
army. 

At  Oswego,  in  1814,  60  miles  south  west  of  the  harbour,  Col- 
onel MiTCHEL  defended  himself  against  a  body  vastly  superior, 
in  which  action  the  enemy  sulTered  great  loss.  In  a  subsequent 
action  at  Sandy  Creek,  200  of  the  enemy  were  made  prisoners 
by  an  inferior  body  of  riflemen  under  Major  Applen. 

The  route  from  Plattsburgh  to  Lake  George,  south  a  distance 
of  one  hundred  miles,  the  jrreatest  part  of  the  way,  is  through  a 
wild,  mountainoi:s,  •'ock^  ''.strict,  whose  sceneries  are  continu- 
ally varying  as  we  progress,  all  of  which  are  truly  majestic.  Be- 
tween mountains  towering  to  the  sky,  are  small  vales,  in  some  of 
which,  very  remote  from  each  other,  are  situated  pleasant  villages. 
Essex,  is  one  of  these  beautiful  spots,  surrounded  by  mountains, 
nhich,   by  tlieir  vicinity,  exclude  every  other  distant  object, 


■M 


172 


]\rEDICAL  SKETCHES. 


iliil 


iim 


except  tlu'ir  aspiring  summits.  These  sublime  sceneries  arc  loo 
circumscribed  to  plenae  more  t'nrin  a  few  <lays.  They  gratify 
the  eye  no  longer  than  the  first  surprising  impressions  remain  on 
the  mind.  This  village  is  situated  thirty  miles  S.  of  Platts- 
burgb.  South  of  Essex,  at  45  miles  distance  from  Platfshurgh, 
ve  arrive  at  Pleasant  Valley.  The  valley,  planted  between 
two  ranges  of  lofty  mountains,  very  regu.ar,  running  nearly  par- 
rallel  with  each  other  eight  miles,  is  a  good  tract  of  land  from 
one  to  one  and  half  miles  wide,  with  settlements  through  its  ex- 
tent, on  which  cultivation  has  made  considerable  progress.  Af- 
ter leaving  Pleasant  Valley,  we  |»I(:nge  into  forests,  with  nothing 
to  attract  the  attention  of  the  traveller,  except  the  continuation 
of  mountains  on  ever}'  side,  which  appear  to  be  thrown  together 
in  wild  confusion  •  all  lofty,  and  rugged  with  rocks.  Their  rela- 
tive heights  may  he  known  by  the  appearance  of  th«ir  summits. 
Those  of  humble  elevation  are  covered  with  full-grown  timber, 
the  more  lofty  and  subliijie  are  covered  with  wood  of  dwarfish 
growth,  while  the  most  towering,  with  bald  heads,  are  capped 
%vith  the  clouds.  Through  a  narrow  serpentine  road,  constantly 
winding  between  the  precipitous  heights,  which  at  some  points  pro- 
ject their  stupendous  perpendicular  sides  faced  with  rocks — from 
whose  tops  the  traveller  is  constantly  threatened  with  overhang- 
ing detached  fragments — after  a  route  of  twenty  miles  or  more, 
without  the  sight  of  a  house,  except  two  or  three  log  huts,  he  ar- 
rives at  the  town  of  Schroon,  so  called  after  a  lake  of  the  same 
iiame  in  its  vicinity.  Here  once  more  the  sceneries  change  : 
tlie  lofty  mountains  gradually  retire  to  a  respectful  distance  .• 
between  which  and  Lake  Chiimplain  are  gently  und  iated  land?- 
on  which  are  exhibited  the  works  of  industrv,  rural  felicitv,  and 
domestic  enjoyments. 

In  this  vicinity  is  situated  Crown  Point,  an  ancient  fortress  in 
ruins,  erected  on  a  projection  of  a  rock,  north  of  Ticonderoga. 
123  miles  ftom  Albany.  Lake  George  lies  west  of  Cham|)Iaiii 
ne.-rly  parallel  with  the  south  extremity  of  that  lake,  and  emp- 
ties itself  between  twenly  and  thirty  miles  north  of  its  south  ex 
tremil}'.  These  lakes  are  separated  by  a  ridge  of  precipitou'; 
mounlaius  risir.g  abruptly  from  their  bank'?.      At  the  south  e\ 


CAMPAIGN  OP  1814. 


173 


Vemtty  o(  Lake  George,  are  seen  the  remains  of  ancient  Fort 
George ;  one  mile  north  of  ^hich  is  the  charming  village  of 
Caldwell  in  full  view,  planted  on  the  bank  of  the  lake,  having  a 
small  tract  of  plain  land  on  its  western  quarter,  bounded  the  dis* 
tance  of  three  fourths  of  a  mile  by  a  range  of  mountains  aspiring 
and  majestic.  The  nceneries  around  the  villags  within  the  view 
of  the  eye  (the  lake  being  not  more  than  two  miles  broad)  are 
inexpressibly  fine  and  pleasing.  Here  one  might  suppose  the 
muses  might  delight  to  take  their  habitations — here  the  poet 
might  in  verse  give  scope  to  his  descriptive  powers,  and  sing  of 
rural  pleasures  and  romantic  enjoyments;  to  whose  notes  the 
sy Ivans  aad  woodland  nymphs  might  join  in  artless  mazy  dance. 
Here,  where  nature  is  at  once  displayed  in  all  her  rural  charms, 
variegated  with  mountains,  forests,  cooling  fountains  and  crys- 
tal floods,  the  painter  also  might  advantageously  employ  his  pen- 
cil. This  beautiful  retreat  from  the  busy  scenes  of  life,  and  noi- 
sy bustle  of  towns  is  a  resort,  during  the  pleasant  months  of  sum- 
mer, for  parties  of  pleasure.  For  vhose  accommodation  an  ele- 
gant hotel  is  built,  which  is  furnished  with  all  the  delicious  vi- 
ands of  e  country.  The  rural  repast  is  supplied  from  the  for- 
ests, the  lake,  and  the  cultivated  tields.  The  senses  are  regaled, 
the  philosophic  mind  feasted  by  the  pleasing  and  astonishing 
works  of  nature,  while  the  body  is  refreshed  from  her  bountiful 
stores. 

Lake  Champlain,  -which  washes  the  borders  of  this  mountain- 
ous and  rocky  district,  will  be  long  remembered  on  the  pages  of 
the  historian,  as  having  been  a  theatre  of  wars  and  ruthful  wasta 
of  human  life,  both  by  hard  fought  battles  and  disease. 

Ticonderoga,  now  in  a  state  of  ruin,  at  an  early  period  of  the 
oountry,  was  considered  of  high  importance  as  commanding  the 
pass  direct  from  Canada  to  the  settlements  on  the  Hudson  and 
in  New-England.  The  French  built  Ticonderoga,  when  they 
possessed  Canada ;  from  whom  it  was  taken  by  General  Am- 
herst, in  the  year  1739.  At  the  commencement  of  the  Amer- 
ican revolution,  this  post  was  taken  from  the  British  by  Colonel 
Allen  in  1775,  and  abandoned  iu  1777.  At  tliat  period  the 
23 


'imi' 


11 

(' 

PiJm 

1 

!| 

,  ''' 

■i 

■ff-.'-^ir- 


174 


TVIEDICAL  SKETCHES. 


i'  I  lie 


bordering  country  was  a  wilderness.    The  importance  of  theso 
posts  will  never  be  forgotten. 

It  was  the  declared  intention  of  Sir  Geoeob  Prevost,  to  po8> 
sess  these  (ioramanding  pot>:  '  «ns,  at  the  time  he  invested  Plattg. 
burgh.  This  would  have  given  him  the  command  of  the  whole 
state  of  Vermont  and  the  northern  district  of  New  York ;  from 
which  districts  resources  for  the  maintenance  of  120,000  men 
might  be  obtained.  The  water  communication  from  this  to  Que- 
bec being  free,  would  have  enabled  the  enemy  with  a  powerful 
army  to  have  threatened  not  only  the  interior  of  the  country 
eouth,  but  the  Atlantic  shoKs ;  and  aided  by  a  fleet  with  a  strong 
party  i:i  New-England,  as  he  anticipated,  might  have  prolonged 
the  war ;  but  which  would  have  terminated  not  in  the  subjuga- 
tion  of  the  nation,  nor  division  of  its  territories. 

The  expedition  against  Plattsburgh,  with  a  view  to  the  con- 
'quest  of  the  country,  would  have  been  an  act  of  madness,  even 
with  an  army  of  50,000  men,  had  not  a  diversion  of  some  of  the 
states  been  expected  by  -the  government  of  Great  Britain  in  its 
favor. 

Without  strong  assurances  of  such  co-operation,  would  so  im- 
portant an  object  have  been  attempted  with  only  15,000  men  ? 

Future  historians,  it  is  to  be  hoped,  will  be  prepared  to  unfold 
xt  train  of  transactions  veiled  in  mystery  ;  the  secret  springs  of 
which  the  public  documents  of  individual  states  had  commenced 
•a  development:;  and  when  fully  exposed  to  the  discerning  eye 
t)f  the  people,  the  delusive,  insidious  charm,  which  bound  their 
liands,  would  have  been  dissolved;  their  native  spirits  of  inde- 
pendence would  have  kindled  anew  in  their  breasts ;  they  would 
have  burst  from  their  mental  inthralment ;  and  while  the  inter- 
nal foe  sheltered  his  guilty  head  in  coverts  from  public  indigna- 
tion, the  enemy  without  wouM  have  felt  the  overwhelming 
power  of  tbp'-  arms. 


ij  ^1 


I'St     t 


1  r 


Pf'lf  -■ 


'M, 


-U' 


CONCLUDING    OBSERVATIONS. 


Many  casualties  concur  to  enfeeble  a  soldier  in  the  field ; 
lome  of  which  have,  in  the  course  of  these  sketches,  been  notic- 
ed. When  a  ntan  is  animated  Mrith  the  object  which  duty  urges 
him  to  accomplish,  if  his  health  is  firm,  and  not  rendered  inac- 
tive by  old  age,  he  will  endure  extreme  fatigues,  and  severe 
colds,  when  time  is  given  him  to  take  his  common  rations  at 
seasonable  hours.  Long  abstinence,  watchings,  and  unremitted 
hardships,  soon  break  down  not  only  the  spirits,  but  strength  of 
an  army.  But  when  well  fed,  they  cheerfully  endure  fatigues, 
colds,  and  expose  themselves  to  the  most  threatening  dangers, 
regardless  of  consequences.  Familiar  with  death,  the  soldier 
floon  forgets  that  the  feeling  of  horror  was  once  attached  to  its 
name.  The  love  of  country,  honour,  the  pride  of  conquest, 
incite  him  to  acts  of  heroism.  When  duty  calls  to  confront 
the  enemy,  he  obey»  the  summons  with  the  same  alacrity,  as 
when  invited  by  the  alluring  voice  of  pleasure  to  his  amuse- 
knents.  Under  these  strong  excitements,  with  a  due  proportion 
of  nutriment,  disease  seldom  assails  the  body.  During  long  inter- 
vals of  inactivity,  the  system  becomes  enervated.  Then  it  is 
that  the  deleterious  agents  exhibit  their  influences  upon  animal 
life.  Then  it  is  that  an  army  sickens  from  cause»  connected 
with  their  local  positions.  The  soldiers  are  attacked  with  disea- 
ses in  the  field,  which  originate  from  their  own  filth  and  impru- 
dence. In  city  cantonments,  additional  causes  co-operate  to  en- 
feeble not  only  the  body,  but  mind ;  productive  of  sickness  and 
military  apathy.  During  periods  of  active  service,  intervals  ot* 
repose  are  necessary ;  but  they  should  be  short,  and,  during  rest, 
unexposed  to  rain  or  snow.  Profound  sleep  is  increased  by  fa- 
tigue ;  during  this  state,  tlie  powers  of  life  are  either  weakened 
or  suspended.  The  cutaneous  secretions  are  diminished  in  pro- 
portion to  the  waste  or  evaporation  of  caloric  upon  tlie  surface.. 


II' 


'.  'fr«»» 


■SH« 


\l 


176 


MEDICAL  SKETCHES. 


.J 


il^R 


fH 


'l! 


The  circumambient  moist  atmosphere  favours  the  process,  whife 
diseased  sensibility  assumes  the  place  of  health.  The  sensa- 
tions of  cold  and  rigors  succeed  with  obstructions  of  the  capilla- 
ry vessels  upon  the  surface ;  which  derangement,  by  a  syra|)a- 
thetic  association  of  parts  remote  from  each  other,  disorders  the 
more  immediate  organs  of  life.  Hence  arise  fevers,  rheuma- 
tisms, dysenteries  and  diarrhoeas ; — diseases,  the  forms  of  which 
arc  governed  by  the  incidents  of  positions,  or  local  eauies,  and 
seasons.      •  :  .;       '     ',  ,•.,  ;•  ,      ■  .   ,■■'■ 'V.'     .1', 

It  is  therefore  favourable  to  the  soldier's  health,  after  a  hard 
march,  to  be  obliged  to  seek  or  cut  his  wood,  to  make  a  fire,  and 
cook  his  provisions.  By  this  gentle  exercise  a  suitable  action 
is  preserved  upon  the  several  organs,  while  the  |)erspiration  oo 
the  surface  is  gradually  evaporated,  without  the  too  sudden 
waste  of  heat ;  the  powers  of  life  do  not  sink,  and  are  further 
supported  by  his  soup,  and  a  short  period  of  rest.  He  rises  re» 
freshed,  and  is  prepared  to  obey  commands. 

There  are  two  principles  which  are  necessary  to  form  the  effi- 
cient soldier.  The  first  is  a  rigid  military  discipline,  which  op- 
erates on  the  mind  of  man  with  a  force  superior  to  the  strong- 
est apprehension  of  dangers.  It  is  this  which  constitutes  the 
courage  and  bravery  of  European  armies,  who  have  no  object  in 
view  but  to  obey  the  commands  of  their  superior  officers.  They 
fight  the  battles  of  a  Prince  without  knowing  whether  the  cause, 
in  which  he  is  engaged,  is  founded  upon  principles  of  justice ;  or 
^vhether  he  is  actuated  merely  by  capricious  motives.  Their 
soldiers,  no  ways  incited  by  objects  which  they  can  appropriate 
to  themselves,  are  but  machines,  while  the  courage  which  they 
possess  is  wholly  artificial. 

But  there  is  a  second  principle  which  renders  a  man  brave ; 
a  knowledge  that  he  possesses  a  native  property — liberty,  inde- 
pendence, and  a  right  of  soil.  These  he  will  support  and  de- 
fend without  compulsion.  In  defence  of  these,  he  instinctively 
assumes  his  arms  and  becomes  a  soldier.  Added  to  this  last 
principle  the  discipline  of  Europe,  the  armies  and  fleets  of  the 
United  States  have  rendered  themselves  irresistible.    And  thus 


Vt 


CAMPAIGN  OF  1814. 


177 


they  will  continue  to  be,  while  the  principles  of  our  government 
remain  unimpaired ;  and  the  pillars  of  our  federated  constitutioa 
stand  firm. 

What  besides  this  innate  bravery  has  given  superiority  to  our 
armies  and  fleets,  over  those  of  the  enemy  ? 

The  unexampled  heroic  achievements  of  our  fleets  on  the 
ocean;  the  attack  on  Little  York,  under  General  Pike;  and 
on  Fort  George,  where  Generals  Boyd  and  Scott's  intrepidity 
and  consummate  bravery  were  conspicuous ;  the  defence  of  Sack* 
ett's  harbour,  under  the  command  of  Maj.  Gen.  Brown  ;  the  sev- 
eral battles  on  the  Niagara,  at  Chippawa,  and  Bridgewuter;  the 
defence  of  Fort  Erie,  and  the  subsequent  sortie  from  that  fort,  by 
the  army  under  the  command  of  Migor  General  Brown  ;  in  which 
actions  Brigadier  Generals  Scwtt,  Riplev,  Gaines,  Porter 
and  Miller  severally,  and  the  oiBcf  rs  and  soldiers  of  the  army, 
generally,  highly  distinguished  tbomselves,  are  ample  testimo- 
flies  of  the  above  position.  To  add  to  the  climax  of  brilliant 
victories,  we  record  with  peculiar  pride  the  battles  of  New  Or- 
leans, and  Plattsburgh,  under  Generals  Jackson  and  Mc'Coomb; 
and  particularly  the  capture  of  two  of  the  enemy's  fleets  on 
Lakes  Erie  and  ChampUiin,  by  Commodores  Perry  and  Mac-^ 
DONOuoH.  These  demonstrate  with  what  high  toned  courage, 
our  soldiers  and  seamen  defend  and  protect  the  rights  and  privi- 
leges of  the  nation ;  and  evince  that  their  superior  valor  is  the 
effect  of  the  principles  of  liberty  and  independence,  associated 
with  our  forms  of  government — principles  imbibed  in  infancy,  a 
knowledge  of  which  increases  with  growth,  and  becomes  mature 
ed  in  adult  age. 


END  OF  CAMPAIGN  1814. 


ill 

m 
m 


f  m  M 


I  ! 


•rT? 


■■CP 


■  J*. 


/;  .  > 


it\i> .  j)i" 


I  :'  '1 


ilU'.u  >■»■ 


.■*>»   ». 


*•» 


I       ■!■>   'Wr.  ,; 


'*lvl     1  >• 


.J  ' 


•t     J  •  'r.'(.j 


'1.1-  (I 


t;-.  •■»< '..  ->•  I' 


i    ...•)«j  u 


'U  V     1  /» 


i', .»    'M 


li  1  i  vt 


I   m 


.  .,  .  J'  « 


NOTES; 


NOTE  A. 


GiRCENiUBii  is  a  township  on  the  east  bank  of  the  Hudson, 
•lireolly  opposite  Albany.  The  town,  which .  occupies  eight 
miies  square,  has  a  diversity  of  soil  and  surface.  Alluvial  fluts 
border  the  river.  Hills  present  themselves  in  the  rear,  distant 
from  the  bank  of  the  river  trom  one  quarter  to  one  mile,  gradu- 
ally rising  until  they  gain  an  elevation  of  200  feet  or  more.  The 
country  exhibits  an  unequal  surface,  diversified  with  hills  and 
Tallies.  The  soil,  in  some  parts,  is  clay ;  in  others,  a  mixture 
«f  clay,  loam  and  sand. 

The  cantonment  is  on  an  elevated  plane,  one  mile  east  of  the 
Hudson.  It  overlooks  the  city  of  Albany  on  the  opposite  bank 
of  the  river,  and  the  adjacent  country,  five  or  six  miles.  From 
this  position  are  seen,  indistinctly,  the  beautiful  villages  of  Troy, 
Lansingburgh  and  Waterford  so  contiguous  to  each  other,  that 
they  ap[)ear  as  one.  Here  are  barracks  for  the  troops  of  the 
United  States'  army,  sufficiently  capacious  to  accommodate 
-loop  men,  with  adequate  quarters  for  their  officers.  On  an  em- 
inence 60  feet  higher,  is  the  hospital,  which  may  accommodate 
one  hundred  patients.  Attached  to  the  hospital  department, 
are  quarters  for  the  surgeons,  offices  and  kitchens-  for  the  subor- 
dinates of  the  hospital.  The  wards  of  this  hospital  are  too  small 
in  thehr  dimensions,  both  for  health  and  convenience ;  being  oi^- 
ly  20  feet  by  1 6,  and  nine  feet  in  height. 

The  elevation  of  the  hospital  is  so  great  above  the  surface  of 
(he  river,  that  the  fogs,  which,  during  the  hot  season,  are  sus- 
pended over  the  fiats  and  villages  on  the  banks,  seldom  rise  to 
't9  summit. 


ill ' 


180 


NOTE  A. 


Upon  the  alluvial  flat  opposite  Albany,  williin  six  years  hat 
been  laid  out  a  village  upon  regular  streets,  which  intersect  each 
other  at  right  angles;  whose  population  hay  rapidly  increased. 
At  this  time  it  contains  about  70  houses.  A  sulphurated  spring, 
about  100  rods  Trom  the  landing  at  Grecnbush,  has  attracted 
much  attention.  During  the  summer  months,  some  resort  here 
for  the  benefit  of  its  waters;  which,  to  my  knowledge,  have  cur- 
ed cutaneous  diseases  by  ablutions  and  frequent  potations. 
Those  waters  would  have  more  frequent  visitors,  if  suitable  baths 
were  erected  for  the  accommodation  of  invalids.  Another  beau- 
tiful village  of  35  houses,  called  Bath,  is  romantically  situated 
on  the  bank  of  Hudson,  one  mile  above  Greenbush. 

The  temperature  of  the  climate  on  the  Hudson  is  more  regu- 
lar than  in  the  same  latitudes  on  the  Atlantic  shores ;  where  are 
experienced  greater  and  more  sudden  transitions  of  weather  than 
here.  The  cantonment,  at  Greenbush,  has  the  reputation  of  be- 
ing healthful;  and  the  country  in  its  vicinity  salubrious. 

The  city  of  Albany,  the  capital  of  the  state  of  New  York,  ift 
situated  one  mile  in  length  on  the  west  bank  of  the  Hudson.  It 
rises  from  the  river  by  a  gradual  ascent  nearly  200  feet  to  the 
elevated  plain.  The  width  of  this  city  is  from  one  quarter  to 
one  half  a  mile.  This  city,  with  the  diversified  country  in  its 
vicinity^  and  the  chain  of  the  distant  Catskill  mountains,  view- 
ed from  the  elevated  lands  of  Greenbush,  forms  a  variegated, 
beautiful  prospecl.  On  the  margin  of  the  river,  the  lands  are 
alluvial  and  rich  ;  while  those  more  elevated  and  uneven,  are  a 
mixture  of  clay  and  sand,  and  barren.  That  part  of  the  city,  on 
the  alluvial  flats,  has  the  reputation  of  being  less  salubrious  than 
that  on  the  hill.  The  want  of  a  rigid  health  police  is  manifest- 
ed by  the  dlthiness  of  some  of  the  streets ;  more  especially  of  the 
back  yards  connected  with  stables  and  kitchens.  In  a  growing 
city,  an  apology  f«r  dirt  may  be  offered,  on  account  of  unavoid- 
able lodgments  on  the  streets  of  materials  for  hou88  building. 
As  the  increase  of  population  introduces  weallii  and  opulence; 
so  these  afford  the  best  means  to  remedy  the  evils  complained  of. 
It  is  too  frequent  that  people  neglect  their  most  important  tem- 
poral concerns — those  conducive  to  health ;  till,  by  repeated  ep- 


I 


NOTE   A. 


IPJ 


idcmlc  (liseatK  8  and  mortnlity,  they  are  roused  to  adopt  mensure<: 
to  obvintc  them.  To  an  opinion  that  inreclioiis  distempers  are 
of  foreign,  rather  than  domestic  orij;in,  tbe  inhabitants  of  cities 
are  mostly  disposed  to  give  credit ;  while  it  leads  them  into  fat- 
al security.  Under  this  impression,  at  the  moment  when  they 
view  a  formidable  disease  at  a  distance,  it  meets  them  unex- 
pectedly at  the  threshold  of  their  doors;  the  direfu'  onsequence 
of  surrounding  filth.  With  a  good  health  police,  Albany,  from 
its  local  situation,  may  be  considered  one  of  the  most  healthful 
cities  in  the  United  States.  With  its  natural  advantages,  it  has, 
in  a  short  period,  increased  in  its  population  beyond  examfile ; 
and  [ircvious  to  the  lapse  of  many  years,  will  be  classed  as  a 
commercial  city  among  the  first  in  the  union.  Agreeably  to  the 
census  of  1810,  the  whole  population  of  AHiany  was  9,350.  Al. 
this  time  (1810)  it  may  be  not  less  than  13,060;  who  occupy 
more  than  1,800  houses  and  stores,  a  Iar2;e  proportion  of  which 
are  bride  There  are  also  10  houses  for  public  worship;  the 
capital  or  state  house,  built  in  a  style  truly  elegant  and  highly 
fmished,  a  new  jail,  three  banks,  with  two  banking  houses,  au 
alms  house,  a  mechanic  hall,  a  powtler  house  for  the  state,  and 
one  also  for  the  city,  an  elegant  state  arsenal,  two  market  houses, 
a  theatre,  &c.  [See  SpatTord's  Gazetteer  of  the  State  of  New 
York.] 

The  majestic  Hudson,  famous  on  the  historic  page,  has  often 
borne  on  its  swelling  tide,  armies  to  defend  its  romantic  banks, 
and  the  fertile  territories  through  which  it  flows.  The  luxuri- 
ant fields,  on  its  borders,  from  its  mouth  to  its  source,  have  been 
often  crimsoned  with  the  blood  of  freemen,  in  defence  of  their 
rights  and  privileges.  The  enemy  has  known,  and  still  knows 
full  well,  the  importance  of  this  river  to  the  possessors.  The 
invading  foe  has  always  directed  his  march  by  this  route ;  and 
has^improved  those  advantages,  w  hlch  its  waters  give,  to  aid  hb 
movements  both  from  New  York  and  Canada.  On  the  banks  of 
the  Hudson,  Burcoyn  surrendered  an  army  of  veterans,  to  the 
undiscipl  .led  yeomanry  of  the  country.  On  the  borders  of  lake 
Champlain,  moving  with  an  army  to  gain  the  source  of  thiaxiv- 
24 


*i  •  M 


I't. 


ti' 


^, 


*f*t 


IMAGE  EVALUATION 
TEST  TARGET  (MT-3) 


.«^% 


■4?^ 


1.0 


1.1 


■>!! 


liitM    |2.5 


125  III  1.4 


i 
I 


1.6 


**- 


P 


/2 


/2 


/: 


/A 


''W 


'/ 


Photographic 

Sdences 
Corporation 


23  WEST  MAIN  STREET 

WEBSTER,  N.Y.  14580 

(716)  872-4503 


^ 


782 


NOTE  B. 


cr,  Prevost  witnessed  llie  defeat  of  his  armed  doliUa,  aad  r»» 
treated  with  discomfiture  aud  disgrace.  v         «  . 

No  section  of  the  United  States  can  bear  testimony  to  more 
hard  fought  battles,  than  the  waters  which  intersect  their  most 
uorUiern  territories.  Time  only  will  disclose,  whether  this  dis* 
trict  will  become  the  seat  of  future  wars — and  whether  a  divi- 
sion of  the  states  will  again  be  attempted  by  this  route.  The 
yeomanry  of  this  district  is  a  barrier,  which  is  continually 
strengthened  by  a  rapid  increase  of  population  r  and  while  di- 
rected  by  a  Tompkins,  will  defy  a  foreign  invasion.  The  state 
of  New  York  alone  can  bring  with  facility,  more  than  one  hun- 
dred thousand  men  to  its  defence ;  which  forbids  a  belief  that 
an  attempt  to  subjugate  the  nation  by  a  division  of  its  territo* 
lies,  at  this  point,  will  be  again  contemplated. 


NOTE    B. 


mi 


|i-U 


i  >  iU  ' 


C/AiiOMEii  and  opium  were  found  beneficial  in  chronic  rheu< 
matism ;  also  Dover's  powders.  Blisters  gave  a  temporary  re- 
lief— their  effects,  however,  were  not  permanent.  When  the 
patient  was  kept  in  a  gently  diaphoresis  between  blankets  24  or 
36  hours,  there  was  always  a  mitigation  of  pain.  Later  experi- 
ence has  demonstrated,  that  the  Vapour  Bath  of  Doctor  Jex- 
MNGS  is  superior  to  any  mode  of  removing  rheumatism. 

Without  detailing  that  train  of  reasoning,  by  which  he  sup- 
ports a  theory,  somewhat  peculiar  to  himself,  of  the  causes  of 
diseases,  aud  their  most  appropriate  mode  of  treatment,  especial- 
ly when  supervening  with  most  morbid  symptoms,  we  shall  mere- 
ly select  from  his  communication,  the  effects  which  have  beeo 
ex[)erienced  by  its  employment. 

Diseases  attended  with  general  coldness  of  the  body,  local,  or 
more  universal  pain  through  the  system,  torpor,  and  mental  de- 
rangement ;  the  patient,  if  not  immediately  relieved,  expires  in 
two  or  three  days,  often  milna  the  first  twentyfour  hours.    The 


NOTE  E. 


tsb: 


IhmiperabTe  coTdness,  and  torpor,  Avhich  exi8t9>  has  led  the  sci- 
entific physician  to  restore  heat  to  the  body  by  the  application 
of  artificial  means.    For  this  purpose,  the  ^varm  ^vater  bath,  bil- 
lets of  >vooil  heated,  hot  ashes,  bladders  filled  Avith  hot  water, 
have,   according  to  the  fancy  of  the  prescribing  physician,  beea- 
applied  in  various  ways  to  the  body.     In  some  instances,  these 
warm  and  hot  applications  have  been  fbllew«d  with  success ; 
while  in  others,  they  have  failed ;  not  because  the  intention  of  the 
application  was  incorrect ;  but  because  the  intention  was  not  com' 
pletely  fulfilled.     The  moisture  which  is  attached  to  the  body, 
and  the  surrounding  clotheS)  frequently  counteract  all  the  bene- 
fit derived  from  the  heat  communicated,  by  favoring  its  speedy 
evaporation  from  the  body ;  whereby  the  patient,  in  a  short  pe- 
riod, is  found  as  cold  and  as  torpid  as  he  was  previous  to  the  em- 
ployment of  those  heated' applicat'ons.     In  these  cases,  internal 
stimulants^  such  as  ardent  spirits,  have  been  resorted  to,  with  ef- 
fects more  frequently  dangerous  than  salutary,  by  inducing  high- 
er degrees  of  excitement  upon  the  larger  internal  vessels,  and 
some  important  viscus,  already  in  a  gorged  state,  without  beings 
capable  of  extending  their  influence  to  the  extreme  vessels  of 
the  skin.     The  substitution  of  Doctor  Jennhjgs'  Spirituous 
Vapour  Bath  remedies  the  evils,  which  are  necessarily  con- 
nected with  the  usual  application  of  heat;  a&its  effects  are  more 
general,  and  as  it  diffuses  throughout  the  system  a  more  equal 
excitement,  without  the  hazard  of  an  exhaustion,  which  follows 
the  employment  of  the  water-batU  heat,  by  itfr  sudden  evapora- 
tion. 

The  following  extracts  from  Doctor  Jennings'  communica- 
tions will  give  a  partial  idea  in  what  cases  the  application  of 
his  Spirituous  Vapour  Bath  is  most  suitable.  A  full  knowledge 
of  his  treatment  cannot  be  obtained  except  by  reading  the  whole 
work,  which  is  scientific  and  incomparable. 

"  Heat  (says  Dr.  Jennings)  is  a  very  powerful  medical  agent, 

and  admits  of  a  more  universal  application  than  any  other  yet 

.  discovered.      It  is  derived  in  certain  seasons  and  countries,  in 

part  from  the  sun,  but  its  principal  source  is  from  the  lungs,  iit 

whioh  it  appears  to  be  generated  by  the  decomposition  of  pure 


f^  I 


[^ 


•,  '.rrr 


184 


NOTE  B. 


il 


»'3l 


vM  \ 


air,  and  from  whence  it  is  conveyed  by  me^gis  of  the  circulation 
to  every  part  of  the  body.  But  if  the  whole  eystem  ia  prostrat- 
ed, the  volume  of  heat,  decomposed  in  (he  lungs,  must  be  less 
than  natural.  In  conseijuence  of  the  feebleness  of  the  excite- 
ment, it  cannot  be  properly  conveyed  to  the  remote  points  of 
the  system.  It  must,  therefore,  necessarily  follow,  that  an  exter- 
nal application  of  an  appropriate  portion  wiK  afford  the  most 
natural  aid  in  this  situutiun.  In  proof  of  this,  it  is  always  agree- 
able to  the  patient. 

*•  Having  tried  the  experiment  an  hundred  times  over,  with- 
out meeting  with  ofiie  exception,  I  assert,  that  in  every  ease  of 
fever  with  exhausted  energy,  and  in  ail  cases  of  direct  debility, 
artificial  heat,  in  an  appropriate  degree,  brings  pleasurable  sen- 
sation to  the  patient,  and  may  be  so  managed  a&  to  produce  cor- 
dial eifects.  In  all  cases  of  debility,  whether  directly  or  indi- 
rectly induced,  there  is  a  prevailing  inclination  to  an  introver- 
sion of  excitement.  Heat,  applied  to  (he  skin,  most  eflectualiy 
counteracts  this  tendency,  and  promotes  a  centrifugal  determi- 
nation. 

"  When  the  surface  is  abandoned  through  want  of  excitement, 
the  skin  collapses,  and  seems  to  lose  its  natural  elasticity.  Heat, 
artificially  applied,  corrects  this  inconvenience.  In  some  in* 
stances  it  may  seem  at  the  tirst  to  produce  a  transient  effect  on- 
ly; but  by  careful  and  well  timed  repetitions,  it  will  at  length 
become  durable.  The  system  artificially  replenished  with  this 
principle,  is  presently  enabled  to  generate  a  more  competent 
supply  for  itself.  But  as  an  excessive  portion  of  wine,  or  any 
other  cordial,  stimulates  too  much,  and  induces  a  morbid  degree 
of  indirect  debility ;  so  also  an  excessive  application  of  heat 
Avill  produce  similar  effects.  In  all  such  cases,  therefore,  spec- 
ial regard  should  be  had  to  (he  feelings  of  the  patient.     ^ 

"  There  are  some  remarkable  and  important  advantages  at- 
tending the  use  of  this  cordial,  which  no  other  can  possibly  claim, 
f  n  every  case,  where  properly  used,  it  produces  a  full  effect,  with- 
out imposing  any  improper  stress  upon  the  central  vessels.  So 
that  in  securing  the-most  pleasant  diffusion  of  excitement,  it  of- 
fers no  injury  to  any  of  the  organs  of  life  j  ordinary  cordials,  on 


NOTE  B. 


IBS. 


the  contrary,  are  depend&nt  upon  the  struggle  vrliich  they  may 
excite  in  the  heart  and  central  vessels,  for  any  and  every  centri- 
fugal effect  which  they  may  produce. 

"  Again,  iit  the  same  time  that  heat,  by  its  stimulant  power, 
invites  excitement  to  the  surface,  it  softens  and  expands  the 
skin,  in  a  wiiy  preparatory  to  receive  the  returning  blooil.  Or- 
dinary cordials  must  accomplish  the  effect,  by  corapelling  the 
feeble  system,  if  indeed  it  can  be  done,  to  assume  an  action  suf- 
ficient not  only  to  resume  all  those  branches  which  it  had  aban« 
doned  because  it  was  not  able  to  maintain  them,  but  also  to 
overcome  all  the  resistance  of  an  almost  lifeless  collapse  of  the 
vessels  on  the  surface,     v.'      *    .  i  . 

"  It  is  true,  that  hitherto  insuperable  difficulties  attended  the 
use  of  this  agent  in  many  cases.  But,  by  the  aid  of  my  porta- 
ble apparatus,  every  difficulty  is  now  perfectly  corrected,  and  the 
application  o^  heat  can  be  made  with  such  precision,  as  fitly  to 
meet  the  most  accurate  intention. 

"  By  raising  an  intense  degree  of  excitement  on  the  surface, 
every  necessary  effect  can  be  produced  with  the  utmost  safety. 

"  Other  powerful  remedies,  when  once  administered,  arc  gone 
beyond  the  leach  of  control,  and  must  have  their  full  effect, 
whether  judiciously  or  injudiciously  administered.  But  if  too 
mu6h  heat  has  been  employed,  it  is  perfectly  within  our  reach 
to  check  its  influence,  by  an  immediate  application  of  cold. 

"  In  cases  of  gout,  rheumatism,  spasm,  cholic,  &c.  when  there 
is  a  morbid  determination,  or  location  of  excitement,  heat  affords 
a  safe  agent  by  which  to  correct  the  dsi  rraination  of  power,  and 
maintain  a  sufficient  degree  of  excitement  on  the  surface,  till  the 
system  can  recover  a  balance. 

*•  After  debility  has  long  prevailed  in  the  system,  by  whatev- 
er cause  it  may  have  been  induced,  the  collapse  of  the  vessels 
of  the  surface  becomes  obstinately  fixed.  The  skin,  therefore, 
looses  its  elastic  feeling — becomes  habitually  and  obstinately  pale, 
and  through  its  privation  of  <;irculating  blood,  is  disarmed  of  its 
power  to  resist  the  cold.     Heat  promises  much  in  such  a  case. 

"It  ni^y  perhaps  be  feared,  that  a  frequent  use  of  heat  may 
induce  debility.  My  experience  warrants  the  assertion,  that  the 
contrary  is  true. 


J 

11 

Ilia!' 

|9 

1 '  l| : 

nja 

'if 

)'■ 

t      i^   ■ 

P 

15 


1if|i 


'.:  'I- 


■'W  , 


m 


f. 


I 


na 


NOTE   C. 


**  The  bath  produces  no  loss  or  vital  fluid,  and  therefore  any 
moderate  degree  of  debility  is  quickly  recovered.  A  pleasant 
expansion  is  given  to  the  vessels  of  the  surface,  and  by  heat 
they  arc  stimulated  into  increased  action.  The  circulating 
blood  is  invited  from  the  centre  to  the  skin.  The  intestines, 
therefore,  by  being  partially  deprived  of  excitement,  are,  for  a 
time,  relaxed — But  when  the  bathing  is  ended,  the  blood  returns 
1o  its  natural  equilibrium,  without  any  subsequent  inconven- 
ience, '•i  '  'i  '  ■-:;•■■  "     ■  :..!'-,  I  •  ''■■:, 

"  It  is  worthy  of  remark,  that  there  is  no  danger  of  taking 
roUl,  especially  in  recent  cases.  The  gass  which  is  used,  is  as 
much  freed  from  moisture  as  atmospheric  air,  insomuch,  that  it 
will  dry  a  damp  sheet.'* 

Dr.  JENNiNGb  is  a  respectable  physician :  he  holds  the  use  of 
his  jfortable  warm  and  liot  bath  by  patent  right.  It  is  not  to  be 
placed  among  the  ephemeral  pretensions  of  those  who  deal  in 
qanck  remedies.  This  new  mode  of  applying  heat,  like  all  oth- 
er useful  remedies,  should  be  employed  under  the  direction  of  a 
ecientiBc  physician  ;  more  especially,  as  its  usefulness  is  circum- 
scribed to  states  of  morbid  action,  which  require  a  knowledge  of 
the  animal  economy,  under  all  states  of  disease  and  health,  to 
direct  with  precision.       f',    (^    .'  ';  :'(^ " -Kt    '    .:   ^.  i;    ;  •:'>:;* 


■     il.:  »:■■ 


I, 


NOTE  C.    v^^'J.  !•.•.:  -'n  .,  . 


Vasci  of  ilisftcclions  reported  by  hospital  Surgeon's  matCt  March^ 
cxhibilins:  the  appearances  of  the  diseased  orgatis  of  those  who 
died  with  the  pneun.unia  notha  of  the  winter  1812-13,  connect- 
ed with  the  sj/mptoms  and  general  treaitncnt  of  the  disease,  r«» 


fi-*- 


,    .       .    (■  .'...,..-         TASE    FIRST*       ,fii..'v»ni  >   •       ;V.  tiJ  .•}1 //'a. 

"  Jamp.!^  Casren,  Gth  regiment  infantry,  was  admitted  into 
fhe  hospital  September  1st,  1812,  sick  with  intejmittent  fever. 


ft 


NOTE    C. 


I8f 


Irom  which  lie  recovered  by  the  ordinary  treatment ;  but  contin- 
ued weak,  having  eome  cough  and  diarrhoea  until  1st  November, 
when  one  eye  was  diseased,  accompanied  with  pain,  and  a  loss 
ef  clear  and  distinct  vision,  which  terminated  in  eight  days  with 
a  loss  of  sight.  The  pupil  was  white  and  opake,  assuming  the 
appearance  of  a  cataract. 

"  November  10th,  he  was  seized  with  violent  pain  in  the  breast 
and  side,  with  common  symptoms  of  pneumonia  ;  fur  which  he 
was  bled,  and  treated  with  medicines  commonly  employed  in 
pneumonic  fevers.     He  died  on  the  13th. 


DIBSECTIOX. 

"  Upon  laying  open  the  abdomen,  the  splceu  was  found  un- 
commonly large,  much  resembling  t'le  kidney  of  an  ox,  and  of 
a  similar  texture,  and  weighed  2  Jfe  2  oz.  avoirdupoise. — The 
lungs  were  tumid,  hard  and  inflamed  ;  adhering  to  the  plcur<'i 
costalis,  in  many  places.  A  membrane  of  coagulated  lymph 
lined  the  cavity  of  the  thorax.  A  considerable  quantity  of  effus- 
ed lymph  was  found  in  its  cavity."  .'^;  '     ,  . 

REMARK. 

The  indurated  spleen  was  probably  the  cause  of  his  cunlinucil 
debility^  after  the  intermittent  fever  was  subdued.  The  state  of 
lungs  was  such  as  were  their  appearance  where  the  patient  did 
not  survive  the  first  stage  of  pneumonia.  In  the  above  case, 
death  took  place  previous  to  the  suppurative  stage,  and  the  in- 
spection evinced,  that  bleeding  was  not  carried  to  tlm  oxteiiij 
which  the  state  of  the  disease  demanded. 


M' 


CASE   SECOND. 

*•' Sullivan  of  the  corps  of  artificers,  34  years  old,  ro- 
bust, muscular,  intemperate,  and  in  a  state  of  intoxication,  took 
a  large  quantity  of  opium ;  soon  after,  was  seized  with  violent 
spasms,  cramp  in  the  stomach  and  breast,  with  vomiting.  After 
recovering  from  the  severe  effects  of  the  opium,  was  seized  witU 
pain  in  the  side,  for  which  a  blister  and  diaphoretic  powders  were 
prescribed. 


1    ii 


188 


NOTE   C. 


"  I  was  called  five  or  six  days  after  his  first  illness  to  vnit 
him,  when  he  was  found  groaning  at  every  breath,  his  hands  al. 
tcrnately  pressed  upon  his  breast  and  head,  and  delirious.  The 
whole  of  the  symptoms  indicated  agonizing  pains  in  the  head, 
breast,  and  si(le.  It  was  said  he  had  been  in  the  above  condi* 
tion  three  hours,  and  previously  complained  of  a  very  severe 
pain  in  his  head.  With  much  difficulty  eight  ounces  of  blood 
was  taken  from  the  arm,  and  a  blister  applied.  He  continued  in 
this  distressed  situation  twelve  hours,  and  died.     - 


DISSECTION. 

"  The  bowels  on  dissection  appeared  perfectly  healthy,  also 
the  liver.  The  spleen  was  enlarged,  darker,  and  of  a  softer  tex- 
ture than  natural.  When  the  sternum  was  raised,  the  lungs  ap* 
peared  in  a  high  state  of  disease.  The  right  lobe  (the  side  affect* 
«d)  was  much  inflamed,  adhering  to  the  pleura,  swollen  so  as 
completely  to  fill  the  cavity  of  the  thorax.  The  left  lobe  was 
slightly  inflamed — a  fleshy  substance  similar  to  a  gland  was 
found  detached  from  every  part,  in  the  abdomen* — This  sub* 
«tauce  is  now  entire,  preserved  in  spirits  of  winew" 


''   .■•■  ■  '■     REMARKS.  »''■..■      .  •  ..    ...    -■/,  : 

This  robust  patient,  it  is  highly  probable,  was,  in  addition  to 
the  disease,  in  a  state  of  intoxication.  The  state  of  the  lungs 
required  a  full  bleeding.  Had  thirty  ounces  or  more  been  takea 
away,  he  might  have  been  saved.  •       i         .    -        • 


CASE  THTRD. 

"  William  Murray,  private  of  the  light  artillery,  was  admit* 
ted  into  the  general  hospital  Ist  December,  1812,  with  a  pneumo' 
iiic  fever.  The  pain  in  the  breast  and  side  was  very  severe. 
He  was  of  a  robust  and  plethoric  habit.  The  treatment  was 
hieeding,  cathartic,  blisters,  submuriate  of  quicksilver,  and  opium. 
He  lived  only  four  days. 


m 


f.y 


KOTE  C. 


18» 


DISSECTION. 


<^Upofi  exafhination,  the  abdominal  vise^  >rere  sound ;  (he 
lungs  highly  inflamed  and  surcharged  with  blood.  A  pint  of 
jrellowish,  or  whey-coloured  lymph  was  effused  int6  the  cavity 
of  the  thorat.  The  inside  oT  the  thorax  was  lined  with  a  thick 
membrane  of  coagulated  lymph.  The  pericardium  contained 
eight  ounces  of  whev->eoloured  lynlph,  in  which  were  floating  co- 
agulated lymph  resembling  cheese  curds.^ 

MfcliAKKS^ 

The  quantity  of  blood  taken  away  is  not  stated,  yet  It  is  most 
oertain,  from  the  robust  habit  of  the  patient,  and  appearance  of 
the  lungs  after  death,  that  a  sufficient  quantity  was  not  taken 
away  in  this  case.  At  the  commencement  of  this  pneumonic 
disease,  the  lancet  was  employed  with  too  great  timidity  in 
most  cases. 

CASE  FOURTH. 

**  William  Moork,  16th  regiment  InfEintry,  was  admitted  a  pfr> 
tient  into  the  general  hospital  atGreenbush,  October  17th,  1812, 
in  a  debilitated  state  of  health,  having  pain  in  the  breast,  with  a 
lore  throat  and  cough—>was  bled  once,  took  a  Cathartic,  which 
relieved  his  throat.  The  cough  continued ;  a  diarrhoea  sooa 
wpervened,  which  continued  until  death,  which  took  place  on 
the  Ist  December.  Gentle  cathartics  were  occasionally  admin- 
istered. His  cough  was  generally  attended  with  expectoratloa 
of  muco-purulent  matter,  which  denoted  an  ulceration  of  the 
lungs.  An  emetic  of  ipecacuanha  was  once  or  twictf  given  to 
promote  expectoration,  and  to  determine  the  circulation  to  the 
iarface.  Paragoric  was  given  to  allay  a  dry  tickling  cough* 
The  diet  was  rice,  chocolate,  milk,  wi.e  occasionally  as  a  stim- 
ulus.  . 


DISSECTION. 


"  Upon  inspecting  the  chest,  the  lungs  appeared  large  and  hard^ 
both  cavities,  and  firmly  adhered  in  several  places  to  the 
25 


)9a 


NOTE  c;. 


pleura.  Both  lobes,  excepting  a  small  part  of  the  left,  were  oT  t 
•dark  purple  colour.  After  making  an  incision  into  the  substance 
of  the  lungs,  and  squeezing  them,  thick  pus  was  forced  by  the 
compression  out  of  the  air  cells.  There  were  found  also  several 
hard  lumps  or  tubercles. 

*'  Upon  examining  the  abdomen,  ihe  rectum,  and  sigmoid  flex- 
ure of  the  colon  were  found  of  a  livid  hue,  very  much  thickened 
in  their  coats.  Those  parts  of  the  intestines  which  rested  on 
the  back  or  psoas  muscles,  assumed  a  dark  and  gangrenous  ap- 
pearance. In  the  cfficum,  or  caput  coli,  were  found  some  hard 
lumps  of  hardened  faeces,  over  which  had  passed  the  watery 
•tools.  These  scybala  are  believed  to  be  frequently  the  cause  of 
cur  obstinate  diarrhwas,  especially  where  the  stomach  and  intes- 
tines have  lost  their  tone,  so  as  not  to  perform  their  offices  of 
digestion.  The  more  solid  parts  are  retained  and  keep  up  irri' 
tation,  while  the  fluids  pass  on  and  produce  a  troublesome  diar- 
rhoca,  which  frequently  continue  a  great  length  of  time. 


CASE    FIFTH. 

"  Thomas  Settlers,  private  in  the  2d  regiment  artillery, 
was  admitted  into  the  general  hospital  at  Watertown,  N.  Y. 
(12  miles  from  Sackett's  Harbour)  about  1st  April,  1813,  v^itii 
pneumonia.  The  pain  in  the  breast  and  side  was  incessant  aad 
severe  several  days.  Respiration  was  laborious,  so  that  tlie  pa- 
tient was  under  necessity  of  sHtingup  in  his  bed  most  of  the  time, 
catching  and  gasping  for  breath — unable  to  make  a  long  and  full 
inspiration.  Repeatedly  bled  and  ^.Istered  without  effect.  He 
died  the  12th  day  after  his  Qrst  indisposition.  ,  ~ , 


DtSSECTION. 

**  On  exposing  the  tliorax,  the  lungs  were  found  contracted, 
tough,  compact,  almost  destitute  of  air  vessels.  The  right  cavi- 
ty of  the  thorax  was  completely  filled  with  serum,  three  pints 
in  quantity  ;  the  lobe  being  so  diminished  as  not  to  occupy  but  a 
very  small  space.  In  this  case,  the  inflammatory  symptoms  had 
subsided,  the  patient  died  hectic,  produced  by  absorption  of  pus, 
and  from  a  hydrothorax.  The  latter  was  probably  the  chief 
agent  of  accelerating  death." 


KOTE  a 


lot 


>id  flex- 
ickened 
sated  on 
BOUB  a|c 

Die  hard 
I  watery 
cause  o( 
nd  iDtes- 
offices  of 
p  up  irri" 
ome  diat' 


OABE  SIXTH. 

*'  Reuben  Smith,  a  private  in  tlie  Otii  regiment,  27  years  of 
age,  admitted  into  the  general  hospital  at  Watertown,  Ist  April, 
1813,  with  the  following  symptoms  :  troublesome  cough,  difficul- 
ty of  breathing,  little  appetite,  and  declining  in  strength,  effects 
of  a  previous  attack  of  the  epidemic  pneumonia.  The  lungs  ap- 
peared the  principal  seat  of  disease.  Small  doses  of  calomel 
and  opium  were  administered  night  and  morning  to  promote  ex- 
pectoration,  which  had  the  desired  effect.  Intermediately 
was  given  a  mixture  of  elixir,  paregoric  and  antimonini  wine  ; 
a  blister  was  applied  on  the  breast  to  remove  a  dull  heavy  pain. 
Three  days  previous  to  death,  the  patient  was  attacked  with 
hemo-phthisis ;  and  at  the  same  time  he  expectorated  a  piece  of 
the  lobe  of  the  lungs,  a  little  hardened  in  texture,  and  partly  ul- 
cerated, which  weighed  over  two  ounces.  The  raising  of  blood' 
continued,  and  he  died  while  he  was  coughing  blood." 

DISSECTIOITk 

"  The  cellular  texture  of  the  lungs,  upon  opening  the  chest,  was 
yellowish ;  the  left  cavity  of  the  thorax  was  filled  with  yellow 
water.  The  lobe  was  large,  hard,  and  adhered  to  the  upper  part 
of  the  cavity.  The  lobe  on  the  other  side  adhered  strongly  and 
uniformly  to  the  pleura  covering  the  riba ;  it  was  large  and  ap- 
peared like  the  liver ;  tender  and  easily  lacerated  with  the  fin- 
gers, entirely  destitute  of  the  spongy  texture  peculiar  to  healthy 
lungs  ;  in  its  superior  part  adjoining  the  clavicle  and  near  the 
trachea,  there  was  a  large  sphacelus.  It  was  evident  from  its  ap- 
pearance, that  a  portion  of  this  rotten  part  had  l)een  removed ; 
and  undoubtedly  was  that  which  was  raised  by  coughing.  Pus 
was  by  compression  squeezed  out  of  the  air  cells.  The  8ub> 
stance  of  the  lobe  was  easily  broken  and  torn  to  pieces.  The 
eavity  of  the  abdomen  contained  at  least  two  quarts  of  water 
similar  to  that  in  the  thorax ;  the  stomach  and  liver  appear- 
ed healthy;  the  gall  bladder  was  larger  thaa  usual,  and_  filled 
with  thinish  biie,'* 


||t  >1  \\\ 


Ji' 


M 


WM  U 


^9•l 


NOTE  C. 


CXaZ  NEVBNTU. 

"  George  Whkrliv,  or  th«  lecond  regiment  of  artillery,  was 
Btlmitted  into  the  hospital  at  Watertown  10th  of  March,  1813, 
in  the  last  stage  of  the  epidemic  pneumonia ;  with  short  breath* 
ing  and  rattling  in  his  trachea,  which  continued  five  or  six 
^eeks;  troublesome  cough,  attended  with  expectoration  of  puru< 
lent  natter;  disturbed  sleep,  accompanied  with  delirious  reveritts 
upon  being  awoke.  When  first  admitted,  the  patient  coughed 
thick  purulent  matter  in  large  quantities ;  became  very  feeble^ 
emaciated  and  sweated  profusely.  Immediately  previous  to  his 
being  sent  to  the  hospital,  he  was  bled ;  after  admittance,  was 
Iriiatered  repeatedly  on  his  breast,  and  took  submuriate  of  quick< 
f ilver  and  ipecac,  combined,  in  small  doses  with  favourable  ef' 
fect^.  Other  medicines  were  occasionally  -administered  as 
symptoms  demanded.  About  the  seventh  week  be  expectorated 
freely  and  largely,  the  calomel  was  discontinued,  and  caraphora< 
ted  tine,  of  opium  and  wine  of  antimony  were  directed  to  ease 
the  cough ;  sweating  now  began  to  abate,  pain  in  the  throat  and 
breast  bad  left  him,  breathing  was  more  free,  appetite  better, 
cough  was  less  frequent  and  expectoration  less.  The  purulent 
inatter  which  hail  been  generated  was  thrown  off,  and  less  ffeem- 
f;d  to  have  been  formed.  The  general  symptoms  were  favoura* 
ble*  and  a  speedy  recovery  was  eipected.      .,  .,iiv  v*i    -u  :.  >' 

"  A  severe  dysentery  at  thi^  lime  supervened  from  some  cause 
ipnknown,  which  precipitated  the  patient  in  three  days  to  the 
l^rave.  The  stools  were  very  frequent,  attended  with  severe 
gripes,  tenesmus,  rapM  prostration  of  strength,  sudden  eraacia- 
lion,  sinking  of  the  eyes  and  contraction  of  the  features  of  the 
&ce.  At  the  moment  of  dissolution,  purple  spota  and  streaks 
appeared  over  the  body,  particularly  on  the  abdooien,  which  in* 
dicated  morti&catiop." 


.      ,"  BISSECTION.       ..\.  ,     ,     _., 

**  The  rectum  and  part  of  the  colon,  upon  inspectiBg  the  co» 
tents  of  the  abdomen,  shewed  strong  marks  of  iniammatioo,  be* 
ing  thickened  in  their  coats,  dark  red,  or  nearly  purple.    The 


NOTE  C. 


193 


Ntrer  wai  found.  The  lung«  were  full  and  appeared  in  a  healthf 
condition,  excepting  one  lobe,  which  had  a  imall  adhesion,  and 
the  other  had  depressed  s[K>ts  of  a  da^-ker  colour  than  the  rest  of 
the  lungs ;  which  evinced  that  these  Kpots  were  once  the  seat  of 
little  ulcers  or  abscesses,  but  now  healed  and  apparentlj  sound 
•i  the  other  parts  of  the  lungs.*'  , 

CASE  EIGHTH. 

^  Landon  C.  Bruce,  sergeant  \n  the  6th  regiment  of  infantry, 
acting  clerk  to  Doctor  Bloob,  hospiral  surgeon,  vis  seized  with 
a  fever  about  the  first  of  November,  1813,  of  intermittent,  in* 
flammatory  and  pneumonic  symptoms,  with  pain  and  soreness 
in  the  breast,  and  cough.  Of  these  complaints  he  so  far  recov- 
ered as  to  perform  the  writing  in  the  hospital,  which  occupied 
three  or  four  hours  in  a  day.  During  his  convalescence  he  was 
in  habits  of  intemperance.  He  still  was  troubled  with  some 
pain  in  his  breast,  and  more  or  less  cough,  and  often  a  diarrhtca 
accompanied  the  other  complaints.  These  had  increased  by  the 
first  of  March,  1814,  to  a  considerable  degree.  About  the  mid- 
dle of  this  month  he  became  so  emaciated  and  debilitated  as  to 
be  unable  to  write  in  the  hospital  office.  As  cough  and  diarrhoea, 
were  aggravated,  appetite  failed.  The  c.  .)ectore.tion  at  this 
time  was  mucus  tinged  with  blood ;  pain  in  the  breast,  not  severe. 
Little  was  taken  by  him  except  opium  to  check  diarrhoea  and  al- 
leviate cough.  '  '"  ■  .1'    '1 

"  April  loth,  a  large  blister  was  applied  over  his  breast.  The 
blister  had  little  or  no  effect.  Some  calomel  bad  been  taken,  but 
how  long  time  it  was  continued,  or  much  in  quantity  sufficient 
to  produce  a  sensible  effect,  is  to  me  uuknown.  13tb.  He  was  so 
weak  as  to  be  unable  to  sit  up,  and  at  times  a  little  delirious. 
16th.  H«  expired. 

UI8SGCTTON. 

*'  The  next  day  I  opened  the  jdy.  The  ab<lomina1  viscera 
were  not  diseased,  except  the  coats  of  some  of  the  large  intes- 
tines (rectum  and  colon)  appeared  to  be  a  little  thickened  and 
inflamed  in  a  small  degree.    Laid  open  the  thorax.    The  left 


'^M 


>  ti  /ii 


f\ 


V 


;  (3 


■J  r' 

iii 

V  i 

n 

'ir'  j 

i   \ 

k 

mi  >.. 

104 


NOTE  C. 


lobe  of  the  langs  entirelj  filled  its  cavity,  and  adhered  tothe 
pleura  costalis,  diaphram,  aternum,  and  pericardium,  wherever 
St  came  in  contact  with  these  organs.  Many  specks  of  pus  were 
discovered  on  cutting  into  the  substance  of  the  lobe ;  but  no  ab> 
scess.  The  right  lobe  had  formed  no  adhesions ;  but  some  schir- 
rons  lumps  were  found  in  its  srhstance.  The  heart  and  pericar> 
dium  were  sound." 

CASK  NINTH. 


•Uii^t  lii'*  ^^.f^* ,,•.."!  r: 


f* 


7f."  -f  •    I 


"  James  Kinney,  0th  regiment  infantry,  was  admitted  into  the 
general  hospital  20th  March,  1&14,  latrauring  under  pneumonio 
symptoms  in  its  advanced  stage.  On  the  28th  of  the  same  month, 
he  was  placed  under  my  charge,  then  complaining  of  pain  in  the 
breast,  short  and  difficult  breathing,  scarcely  able  to  articulate ; 
with  the  above  symptoms,  and  a  diarrhoea,  with  which  he  was 
attended,  had  become  emaciated  aud  debilitated.  A  blister  was 
applied,  which  relieved  the  pain  in  the  breast ;  at  the  same  time 
aubmuriate  of  quicksilver,  opium,  and  tartrite  of  antimony  com- 
bined, were  administered  in  small  pills  night  and  morning;  each 
pill  containing  one  grain  of  the  submuriate,  one  grain  of  opium, 
and  one  fourth  grain  of  tartrite  of  antimony  ;  occasionally  a  pill 
of  opium,  per  «r,  when  too  great  determination  to  the  bowels  was 
perceived.  Camphorated  tincture  of  opium  was  also  given, 
when  the  cough  was  troublesome,  to  take  off  the  irritation  from 
(he  lungs.  This  treatment  was  pursuet.  one  fortnight.  The 
pills  produced  a  free  expectoration,  which  was  aided  by  soft  di- 
luents. About  this  time  one  gill  of  wine  was  allowed  a  day^^  i 
"  The  laborious  respiration  still  continued.  Small  pains  now 
and  t'ien  returned,  but  confined  to  the  left  side.  His  general 
iiealth  failed,  and  he  became  more  emaciated.  Suspecting  that 
there  might  be  an  effusion  of  lymph  mixed  with  pus  in  the  tho- 
rax, on  the  20th  of  April  an  examination  was  made  as  to  those 
symptoms  wliich  indicate  an  hydrothorax  or  an  empyema.  He 
had  cold  sliiverings ;  no  anlematous  swellings  of  the  lowc**  ex- 
tremities; nor  had  he  dreamed  of  drowning;  all  of  which  occa- 
sionally occur.  The  symptoms  which  might  lead  to  a  suspW 
rion  of  empyema  were,  he  had  a  pneumonia ;  the  left  side  of  the 


NOTE  C. 


W» 


ibonx  was  visibly  larger  than  the  other;  the  spaces  between 
the  ribs  on  that  side  were  more  tense  and  distended  than  tii^ 
other ;  in  the  left  side  there  had  been  more  pain  than  the  other. 
The  most  unequivocal  symptom  of  a  fluid  in  the  cavity  was  the 
fluctuation  lieard,  when  a  sudden  shake  was  given  by  turning 
him  on  the  opposiie  side.  The  noise  was  not  much  unlike  the 
agitation  of  buttermilk  in  a  churn. 

"  By  the  advice  of  Hospital  Surgeon  Blood,  I  tried  the  effects 
of  a  large  blister;  the  result  was  what  was  expected.  It  ans^ 
wered  bo  good  purpose.  The  effusion  being  the  termination  of 
a  severe  pneumonia,  and  the  collection  of  long  standing,  and 
great  in  quantity,  blistering  was  believed  to  be  a  very  inefficient 
remedy  in  such  a  case.  The  inflammatory  stage  had  subsided 
more  than  a  fortnight.  The  operation  of  paracentesis  appeared 
to  be  the  last  resort. 

**  On  the  24th  April,  an  opening  was  made  between  the  sixth 
and  seventh  ribs,  near  where  the  external  oblique  muscle  of  the 
abdomen  indigitates  with  the  serratus  major  anticus ;  or,  (which 
brings  it  to  about  the  same  point)  at  an  equal  distance  between 
the  ensiform  cartilage  of  the  sternum,  and  the  spine.  I  made 
the  incision  through  the  skin  and  muscles  with  a  common  «scaN 
pel,  and  punctured  the  pleura  with  a  lancet)  a  quart  t  of  an  inch 
long.  The  pus  flowed  in  an  uninterrupted  stream.  About  one 
quart  was  taken  away,  at  this  time,  when  the  patient  began  to 
grow  faint,  and  I  closed  the  orifice.  This  first  discharge  of  mat- 
ter procured  him  much  relief  in  his  breathing.  He  couglied  less, 
slept  better  the  ensuing  night  than  he  had  done  for  three  weeks 
previous.  The  orifice  was  opened  again  the  next  day,  [25tb] 
from  which  was  discharged  more  than  one  pint  of  matter.  Al- 
though his  breathing  was  considerably  relieved,  yet  his  pulse 
became  more  hectic,  and  bis  strength  failed.  [26th.]  Being 
weak  and  exhausted,  and  respiration  not  \evy  laborious,  no  dis- 
charge was  attem[)ted.  On  the  27th,  the  orifice  was  again  op- 
ened, and  a  pint  and  half  matter  taken  away.  The  last  dis- 
charge was  of  the  fluid  consistence  of  buttermilk,  and  of  a  green- 
ish colour,  very  offensive,  so  as  to  contaminate  the  whole  room 
viiih  a  nauseous  smell.     Pulse  now,  small,  hard,  frequent ;  he 


*t|ifi 


■•1  i 

i' 


I) 


II  ■  ■ 
'  i    ' 

t    :    :  ! 


w^ 


100 


KOTE  C. 


wu  restless,  and  had  little  or  no  appetite.  At  this  period  ho 
took  wine  and  soft  nourishing  diet,  as  much  as  h)s  stoaiach  coaM 
bear,  with  a  pill  of  opium  at  night.  From  this  time  there  waa 
but  little  discharge,  except  when  raised  up.  His  breath  became 
Tery  offensive,  and  his  pulse  smaUer  and  more  frequent,  nntil 
May  4tb,  whea  he  expiredv"  '         '   jj  <  ■; 

CA8£   TENTHk 

**  Thomas  FAMtiNo,  11  th  regiment,  was  placed  nnder  Wf  oarei 
the  last  of  April,  1814.  Upon  examination,  be  was  found  la- 
bouring under  a  chronic  complaint  of  the  lungs,  consequent  to 
pneumonia.  At  this  time,  his  complaints  were  some  pain  in  the 
left  breast,  hoarseness,  troublesome  cough,  difficulty  of  breathing, 
little  appetite.  Previous  to  his  present  indisposition,  he  had  an 
hemophthisis.  He  was  bled  moderately ;  a  blister  wa\i  applied  to 
the  affebted  breast ;  a  pill  of  one  grain  of  submuriate  of  quicksil- 
ver, one  grain  of  opium,  and  one  fourth  grain  of  tailrite  of  anti- 
mony was  administered  every  night,  and  was  continued  one 
week  with  some  good  effect,  by  promoting  an  expectoration ; 
but  his  breathing  was  no  better.  Profuse  night  sweats  super- 
vened, with  loss  of  speech,  delirium  and  anasarcoua  swellings. 
He  died  ten  days  after  I  made  my  first  prescriptions. 

DISSEfTION. 

"  May  6th.  ITpon  opening  the  abdomen,  it  was  found  to  contain 
about  one  and  half  pint  of  \tater.  The  intestines  were  much 
thickened  and  corrugated,  bearing  strong  marks  of  inflammation. 
The  caput  coli  and  ascending  part  of  the  colon  appeared  to  be 
free  from  inflammation,  but  much  distended  with  wind.  The 
stomach  and  spleen  appeared  sound.  The  liver,  as  in  health 
and  natural,  except  the  ligamentum  teres  running  along  a  fissure 
on  the  under  side,  passing  through  a  foramen  in  the  same  place 
where  the  fissure  should  be.  The  foramen  was  free  and  open, 
and  sufiiciently  large  to  admit  my  little  finger  by  the  side  of  the 
round  ligament. 

Upon  raising  the  sternum,  the  lungs  were  found  exceeding 
farge  in  either  cavity.    The  right  lobe  had  some  slight  adhe- 


NOTE  C. 


lOT 


MOM  at  the  back  and  upper  part  of  the  cavity  of  the  thorax.  A 
small  portion  of  the  lobe  immediately  under  the  clavicle,  and 
near  the  fli)ine,  had  lost  its  natural  spongy  texture,  and  resemt- 
bled  that  of  the  liver.  Upon  cutting  into  this  part,  a  small 
quantity  of  pus  was  found  in  the  cells. — The  left  lobe  was  very- 
large,  and  distinctly  divided  by  a  fissure  running  longitudinally, 
dividing  the  front  from  the  back  part.— This  fissure,  or  which 
was  more  like  an  incision  made  with  a  knife,  was  aboist  an  inch 
and  half  deep,  'the  front  division  .  this  lobe  appeared  healthy 
and  natural,  without  any  adhesions ;  the  back  portion,  (whicb 
was  rather  larger  than  th6  front,  and  by  itself  almost  as  large  as 
a  common  lobe)  adhered  to  the  pleura  in  every  part.  It  exhib- 
ited strong  marks  of  inflammation,  being  of  a  dark  purple  colour, 
and  considerably  hardened.  Upon  cutting  into  every  portion, 
particularly  the  upper  and  back  part,  every  cell  discharged  thick 
pus  in  abundance.  Indeed,  wherever  an  incision  was  made, 
the  wound  appeared  like  a  mass  of  thick  pus,  connected  only  by 
the  thin  membranous  textui  of  the  iDngs ;  not  much  dissimilaf 
to  a  hOney-comb  if  filleil  with  thick  pus." 


",.•:.'"?  ►>!..    ■  tABG   ELEVENTH. 

"  DaKiel  Cathburt,  23d  regiment  infantry,  was  adntitted  into 
the  hospital  at  Brownville,  10th  March,  1814,  with  a  pulmonic 
complaint.  The  greatest  part  of  the  preceding  winter,  he  had 
been  sick  at  Sackett's  harbour,  previous  to  his  removal  to  Brown* 
ville.  This  patient  had  a  bad  cough,  with  slight  pains  in  his 
breast,  and  difficulty  of  breathing,  some  diarrhoea,  edematous 
swellings  of  the  legs,  which  were  reduced  by  the  spiral  bandage. 
With  the  above  symptoms  he  was  much  emaciated.  Blisters 
were  applied  upon  his  breast;  was  ordered  at  night  a  pill  of  sub- 
muriate  of  quicksilver  and  opium;  after  taking  the  above  medi^ 
cine  a  few  days,  an  expectoration  took  place ;  to  assist  this  and 
quiet  an  irritating  cough,  camphorated  tine,  of  opium  was  admin* 
i«tered  with  soft  mucilaginous  drinks.  The  diet  was  principal- 
ly milk ;  and  the  patient  was  indulged  with  wine  every  day  tilf 
his  death,  which  was  on  th6  10th  of  May. 


'1 

1 

ri 

I 

1 

<      '  n 

'  1 

i 

;  1 

II 

^i 

il 


iil 


11;.  ii 


isv 


:;:li 


!i! 


\i 


(' 


^■ii,IJ  w^i,g)|iHU|Ui^iip^M)||H^ii 


ion 


NOTE  C- 


».'ii* 


OtSSECTIOK. 


.('>■, 


"  On  opening  the  abdomen,  the  coats  of  the  intestines  were 
found  very  much  thickened  and  corrugated,  and  appeared  to 
have  been  highly  inflaaied.  The  stomach  was  contracted,  the 
Uver  was  whitish  with  a  yellowish  cast.  The  vcsicula  fellis 
contained  but  a  small  quantity  of  bile ;  its  coats  were  much 
thickened,  contracted,  and  appeared  to  have  been  inflamed. 
Having  sufisred  from  diabetes  a  considerable  time,  I  was  induc> 
ed  to  examine  the  I  idneys.  To  the  upper  part  of  that  on  the 
left  side,  there  was  an  appendage,  nearly  as  large  as  a  midling 
sized  auricle  of  the  heart,  and  in  resemblance  somewhat  lilce  it, 
but  in  texture  soft  and  tender  as  the  liver  or  spleen.  It  was  ea- 
sily torn  with  my  fingers.  The  right  kidney  appeared  natural 
excepting  the  ventricle  which  empties  itaelf  by  the  ureter,  was 
larger  than  usual.   , .      ,  _,...,,.,.    ,  .,.a,w<      .  ■.  «i  - 

*'  Each  cavity  of  the  thorax  contained  three  pints  of  water, 
rather  serum,  limpid  and  glutinous,  resembling  whey  in  colour. 
The  right  lobe  was  contracted  to  half  its  natural  size,  the  upper 
part  consolidated  and  hardened,  feeling  and  appearing  like  a 
piece  of  heart  boiled.  ^hesions  had  formed  to  the  spine,  ribs, 
clavicle  and  pericardium.  The  lobe  was  so  much  drawn  to  the 
spine,  that  no  adhesion  existed  between  it  and  the  ribs  of  the  au- 
terior  part  of  the  thorax.  In  the  upper  part  of  the  lobe  immedi- 
ately under  the  clavicle,  there  was  an  abscess  as  large  as  a  goose 
egg.  The  substance  of  this  part  was  destroyed.  There  was 
found  adhering  to  the  pleura  and  lungs,  a  membrane  of  coagulat- 
ed lymph,  and  some  similar  thick  pieces  resembling  what  is  com- 
monly called  mother  of  vinegar.  The  left  lobe  appeared  little 
diseased ;  but,  on  cutting  into  the  substance,  drops  of  pus  were 
squeezed  out  of  its  cells.  There  were  slight  adhesions,  nothing 
more,  it  is  presumed,  than  many  have  for  years,  who  ei^oy  good 
health.  The  pericardium  contained  a  fluid  similar  to  that  in  the 
thorax,  but  more  glutinous.  This  man  was  25  years  of  age, 
light  complexion,  of  a  delicate  constitution.'*  ,^ 


."J^  if 


■■?T, 


r^-..-',i4'-..t- 


(199) 


Ld 


1    Jl 

w 

<i 

't 

1      1 

'  -f 

.It 


NOTE  D. 

Doctor  Gallup  observes  in  his  treaHse  on  epidemics,  page 
70,  that  "  the  winter  epidemic  or  1812-13,  appeared  among  the 
soldiera  at  Burlington  some  weeks  before  it  did  amongst  the  in- 
habitants of  that  place.  It  appeared  also  among  the  soldiers  at 
Plattsburgh  and  Sacltct's  harbour,  and  also  in  the  camp  at  Oreen- 
bush,  opposite  Albany.  No  satisfactory  account  (he  observes) 
has  ever  been  given  to  the  public  relative  to  the  diseases  at  Bur- 
lington. I  have  solicited  information  from  resident  physicians 
there,  but  have  obtained  none.  By  information  from  some  of 
the  most  respectable  inhabitants  of  the  place,  and  also  from  oth- 
ers residing  there  at  the  time,  I  am  warranted  in  stating,  that  for 
some  time,  it  was  common  for  eight  to  twelve  to  die  in  a  day. 
The  whole  number  is  said  to  be  not  less  than  seven  or  eight 
hundred  in  four  months.  The  number  of  soldiers  stationed  at 
this  encampment  was  about  twenty  five  or  twenty  eight  hun^ 
dred." 

Thus  far  is  Doctor  Gallup's  statement ;  upon  which  (if  any 
remark  is  necessary)  we  shall  observe,  that  if  the  Doctor  had  ap- 
plied to  the  surgeons  of  the  hospital  at  Burlington,  rather  than 
citizens,  for  information  respecting  deaths  in  the  army,  he  would 
not  have  committed  so  considerable  an  error  respecting  numbers. 
The  troops  at  Burlington,  in  the  winter  1812— 13,  did  not  num- 
ber over  sixteen  hundred,  and  the  deaths  did  not  exceed  twa 
hundred.  The  mortality  was  greatest  during  the  month  of  De- 
cember, while  stimulants  were  the  principal  remedies  employed. 
The  antiphlogistic  regimen  was  commenced  under  my  direction 
the  first  week  in  January,  when  micommon  mortality  ceased,  al- 
though cases  of  new  attacks  were  not  less  frequent. 

Doctor  Gallup  is  c^^^ect  where  he  considers  "  the  exposures 
and  fatigues  of  a  can^^.  life  to  men  unaccustomed  to  it,  might 
have  a  share  in  rendering  the  soldiers  the  first  victims  of  the  di&> 


I 


l\i\ 


ll 


i'3i.; 


ill  »f 


1  i 


1    , 

1; 


ii 


W^l 


m'i\ 


^ 


2flii 


NOTE   U. 


V 


ease.'*    It  being  true  "  that  it  appeared  among  the  troop*  two  or 
tliree  weeks  earlier  than  among  the  citizens,"  ^vho  eventually 
sutTcred  with  no  less  severity  troin  it,  but  in  some  instances  much 
greater.     Id  the  month  of  February,  the  numlier  of  deaths  agree- 
ably td  the  offici'al  report  of  Doctor  LovcMi,  did  not  exceed  three 
in  a  hospital,  which  contained  more  than  one  liundrcd  patients 
through  the  whole  time;  when  during  the  same  mouth,  th»re 
were  seventy  three  deaths  of  citizens  in   the  small  village  of 
Burlington.     This  last  fact  was  communicated  to  Doctor  Lov- 
eiAj^  by  a  highly  respectable  clergyman  of  the  town.     The  re- 
mark in  a  medical  view  is  especially  important,  that  while  the 
soldiers  were  under  an  antiphlogistic  practice,  the  citizens  were 
treated  by  stimulants. 

*'  A  depression  of  mind  from  a  repulse  immediately  before,  un- 
der General  Disarborn,  in  an  attempt  to  invade  Canada,"  (as 
conjectured  by  Doctor  Gallup)  could  not  have  existed ;  when 
there  had  been  no  repulse  which  this  division  experienced. 
Neither  did  General  Dearborn  immediately  command  the  ar- 
my on  the  lines  of  Canada;  which  had  an  invasion  been  intend- 
ed, he  would  have  headed  in  person.  After  General  Van  Ren- 
seleer's  disastrous  battle  at  Queenstown,  and  failure  of  General 
Smttb's  expedition,  no  hostile  movement  against  the  enemy 
was  contemplated  at  that  late  season  of  the  year.  The  officers 
of  the  army  well  understood  that  General  Bloomfield's  move- 
m^it  towards  the  lines  of  Canada  was  only  a  feint  to  draw  the 
attention  of  the  enemy  from  Upper  Canada,  to  aid  General. 
^MTTH  in  his  expedition. 

No  person  can  more  respect  the  opinions  of  Doctor  Gallup 
than  myself;  especially  as  to  the  nature  and  treatment  of  epi- 
demic diseases,  particularly  the  pneumonia  notha  of  1812 — 18. 
A  similar  treatment  had  been  pursued  by  the  surgeons  of  the  ar- 
my, in  O|iposition  to  the  sentiments  of  very  respectable  physi- 
cians in  that  part  of  the  country.  A  concise  view  of  which  was 
published,  at  that  period,  in  the  Arous  at  Albany,  and  with  some 
additions  may  be  seen  in  the  Medical  Repository  for  1813 
jkOd  1814,  printed  at  New^York.  >     «      - 


^201  ) 


llllll 


KOTE    E. 

In  a  hie  Amencan  eaition  of  GoIdamith^B  History  of  Eng* 
land,  by  the  Reverer;]  Manlt  Wood  of  Exeter  College,  Oxon. 
ig  a  summary  of  events  to  the  year  1815,  published  by  a  profes< 
8or  of  Harvard  University  at  Cambridge,  (who  has  aclcnowledg- 
ed  himself  the  author,)  from  which  the  following  abusive  state- 
ment  is  extracted. 

*'  The  border  war  against  his  mjyesty's  North  American  Col- 
onies, produced  no  important  results }  but  was  incalculably  dis- 
tressing to  the  inhabitants  of  both  frontiers.  In  the  course  of 
the  season,  several  considerable  battles  were  fought.  Little 
York,  the  capital  of  Upper  Canada,  was  taken,  sackedy  and  the 
fublic  IndUkngs  manionly  destroyed^  in  the  former  part  of  the 
campaign,  by  troops  under  General  DEARBoax;  but  the  Amer- 
icans were  soon  forced  to  abandon  it  with  considerable  loss." 

What  base  pusillanimity  is  represented  in  the  above  para- 
graph !  ^^ forced  to  abandon  the  placCy*  when  an  enemy  was  not 
within  the  distance  of  90  miles  t  A  more  astonishing  and  impu- 
dent mistatement  never  was  befoire  published,  directly  in  the 
face  of  correct  official  documents. 

It  is  much  to  be  lamented  that  any  one,  but  more  especially 
a  member  of  the  Massachusetts  Historical  Society,  holding  a 
highly  respectable  place  in  an  important  public  institution,  es- 
tablished for  the  advancement  of  science,  morality  and  religion, 
ihould  be  so  lost  to  a  just  sense  of  his  situation,  as  to  have  giv- 
en vent  to  such  virulent  party  feelings— as  to  betray  a  disregaid 
of  facts,  as  well  as  common  decency. 


i«v'.l/  - 


;!,      .  . . , 


i4 

i        ,' 

km 


Ift! 


1!! 


'  •■ . 


1'^ 

1' 


!l 


ir 


f^ 


(  20^  y 


% 


i 


\ 


NOTE    F. 

In  justification  of  measures  pursued  by  General  Boyd,  while 
he  commanded  the  army  at  Port  George,  we  state,  that  the  gal- 
lantry of  no  one,  on  that  memorable  day,  when  Fort  Geor^o 
surrendered,  was  more  honorably  mentioned  than  his  was,  arter 
the  action ;  in  which  he  not  only  led  his  brigade  up  the  banli, 
defended  by  a  line  of  the  enemy  eligibly  posted  for  defence ;  but 
by  his  animating  address  to  his  troops  while  in  the  heat  of  bat- 
lie.  It  is  in  my  power  to  state,  being  on  the  battle  ground  im- 
mediately after  the  action,  near  four  hundred  men,  including 
those  of  both  armies,  either  killed  or  wounded,  extended  on  the 
high  bank,  intermixed,  a  length  of  200,  and  breadth  of  15  yards. 
This  alone  demonstrates  the  ground  was  disputed  nearly  at  the 
point  of  the  bayonet,  until  the  enemy's  line  broke.       ^       '^  = 

From  information  given  by  oflicers,  some  sections  of  our  army 
actually  engaged  the  enemy  at  the  point  of  the  bayonet. 

The  following  extracts  of  letters  from  Officers  of  high  grade, 
express  Hie  sentiments  of  the  offi^iers^  generally ^  of  the  army, 
respecting  the  conduct  of  General  Boyd  on  that  occasion. 
Extract  of  Major  General  Lewis'  letter  to  the  Secretary  of 
War. 

•'  Of  General  Boyd,  I  feel  it  a  duty  to  do  justice  to  his  intrep- 
vl  conduct  at  the  landing  of  our  troops  on  the  Canada  shore,  at 
Niagara.  His  brigade  made  the  landing  under  a  heavy  fire  of 
musquetry.  It  was  instantly  formed,  and  he  led  it  up  the  baok 
with  great  gallantry,  and  was  the  first  himself  to  gain  it."    '<' 


Extract  of  General  P.  B.  Porter's  letter  to  the  PresidaU  of 

the  United  States. 

"  At  the  taking  of  Fort  George,  on  tte  27th  May,  the  Amer- 
ican troops  landed  in  succession — 1st,  the  advance  on  the  righ*/ 


NOTE  P. 


sofa 


anAer  (he  command  or  Lieutcnanl  Colonel  ScoTt — 2d,  Botd's 
brigade— 3d,  Winder's,  and  lastly,  Chandlbh's.     The  landing 
or  General  Boyd's   brigade,  was  eflected  (as  well  as  that  of 
Scott's  command)  under  a  heavy  shower  of  miisquctry  from 
the  enemy,  who  lay  on  the  margin  of  the  lako.     But  such  was 
(he  promptitude  and  order  with  which  the  troops  were  formed 
and  led  into  action,  that  the  enemy  was  beaten  by  the  time 
Winder's  brigade  began  to  debark.  i 

"  General  Boyd  and  his  brigade  porticipated  largely  In  the 
well  earned  honors  of  the  day ;   and  the  expedition  and  order 
with  which  his  brigade  landed  and  formed,  and  the  personal  gal- 
lantry, were  s|)okea  of  Ihrouglioul  the  army  io  terms  of  the  high- 
est commendation.**  .    .'     >u,  >  .1  •  1, "  !       /      .c    '! 
>......,...<  »..,••.  .'..I    •.,.•.>■    .       ,.,,  ».......?,,..    ■■  r  » 

Exlracl  cf  General  Miller's  htter  to  a  General  in  Boston, 

"  I  served  in  his  brigade  (General  Boyd's)  at  the  capture  of 
Fort  George  on  the  Niagara.  Lieutenant  Colonel  SCott  led 
the  advance  and  struck  the  shore  first,  followed  immediately  by 
our  brigade,  which  landed  in  succession  from  right  to  left,  and 
formed  under  a  most  destructive  fire  from  the  enemy  who  lined 
the  bank  for  some  hundred  yards.  The  contest  was  principal- 
ly, or  all  over,  before  any  other  brigade  landed. 

"  General  Boyd  was  the  senior  officer  on  shore.  I  have  ever 
considered  his  conduct  on  that  occasion  brave,  animating,  in' 
trepid,  and  officer  like." 

General  .Miller,  speaking  of  the  capture  of  Fort  GeorgC;, 

says— •       *'»   "''  —'■■         -■-■ki 

"  General  Boyd  inspired  the  whole  by  his  zealous  rnd  animat- 
ing conduct.  He  rushed  up  the  steep  bank  at  the  head  of  his 
k-igade,  when  after  about  fifteen  minutes  sharp  fighting,  the 
charge  was  given,  and  the  enemy  fled.  General  Boyd  Avas  sen- 
ior officer  in  the  battle,  and  proclaimed  the  victory  by  three 
cheers— to  him  and  Scott,  the  army  acknowledged  a  preemi- 
nent claim  to  the  honors  achieved.  «   u;.,  M        .      '. 

"  This  conquest  I  have  ever  considered  one  of  the  most  bril- 
liant achievementg  during  the  war,  the  sortie  at  Fort  Erie  ex- 
cepted." 


II 


11 


i 


I 


■■If';  ' 


m  r 


i    i 


■ 


TT^ 


S04 


NOTE  P. 


il^ 


1:1^ 


m 


... 


i  I 


The  foITowIiiff  cfocument  exhibits  the  orden  hf  which  OtMf> 
al  Boyd  wa«  governed  lubsequent  to  that  period,  when  General 
Drarboen  wai  ordered  from  the  command  oT  the  army  at  Fort 
George.  .;   ,  „ . 

**War  DrpartmerU,  My  7,  1813. 

"  Sin, — General  Dearborn  being  about  to  withdraw  Trom  the 
command  oT  the  army,  until  his  health  shall  be  re-established, 
this  trust  will  devolve  upon  you,  as  the  senior  officer,  until  tite 
arrival  of  some  person  fo  whom  it  will  be  specially  assigned. 
*  During  this  period,  you  will  pay  the  utmost  attention  to  the  in* 
Btruction  and  disciplining  of  the  troops,  and  engage  in  no  aflair 
with  the  enemy  that  can  be  avoided.  The  orders  of  Generals 
Hampton  and  Lewis  you  will  obieyk 


jo;j 


"  I  am,  with  great  respect,  your  most  obedient  servant, 

JOHN  ARMSTRONG.'* 


•|Vj  ,fj   f.ilj    T^ 


The  above  documents  have  been  already  published,  and  com* 
ing  from  officers  of  most  respectable  standing,  when  more  gene^ 
ally  Icnown,  will  remove  every  aspersion  which  has  been  cast 
upon  Gene)ral  Boys  by  the  public^  while  he  commanded  at  Fort 
George. 

The  aggregate  of  the  at*my  at  Fort  George  and  its  dependen* 
ties  was  about  5000.  From  an  estimation  of  numbers  sick  in 
general  and  regimental  hospitals,  it  was  my  persuasion^  but  lito 
tie  more  than  one  half  of  the  army  were  capable  of  duty,  at  one 
period  during  the  summer  months.  The  officers  equally  suffer* 
ed  with  the  ranlc  and  file.  This  has  been  already  expressed  in 
page  66.  It  was  repeatedly  stated  to  myself  by  officers,  that 
they  were  on  duty  every  other  day.  ;     i,«     ■ 

Wherein  the  comparative  strength  of  the  two  armies,  as  to 
aggregate  numbers,  is  noticed,  page  91,  it  is  not  designed  to  im* 
pute  to  General  BoYb  a  want  of  courage;  no  officer  was  ever 
heard  to  suggest  that  he  would  not  have  attacked  the  enemy  in 
their  lines,  if  he  had  been  at  liberty  to  have  acted  offensively. 
If  he  was  unfortunately  placed  under  circumstances  by  superior 
authority,  which  operated  to  his  injury  in  the  public  mind,  a 
full  exposition  of  which,  prudence,  at  the  time,  forbade  ;  the  in- 


1'.  >  t 
; 


NOTE   F. 


20d 


justice  is  to  be  attributed  to  those  ordcra,  which  restrained  hia 
native  energies,  and  prevented  bini  the  acquisition  oT  those  high 
military  honours,  for  which,  in  early  life,  he  assumed  the  profes- 
sion of  arms ;  for  which  he  always  thirsted,  and  for  vihWa  he 
has,  at  all  times,  displayed  the  highest  ambition  to  expose  his 
life. 

While  enumerating  the  several  causes  of  disease,  to  which  the 
army  was  subjected  at  Fort  George,  the  sinl&s  were  noticed  ia 
pages  66  and  70  as  one.  No  neglect  on  the  part  of  General 
fioTD  is  here  intend.'d.  The  officers  of  the  amy,  la  all  things 
connected  with  cleanliness,  were  governed  by  their  perceptions. 
To  the  c^e  the  enoampnMut  appeared  in  fine  order,  and  very 
«lean.  Nevertheless,  offensive  effluvia  from  the  sinlcs,  (whea 
the  wind  was  from  that  quarter,  from  which  it  blows  four-fifths  of 
the  time  during  the  summer  months)  were  noticed  by  myself  and 
others,  who  accasionally  visited  the  encampment  from  a  posi- 
tion surrounded  by  a  purer  atmosphere.  A  report  of  tlie  exbtent 
(act,  however,  is  not  intended  as  a  censure  on  any  one.  The 
observation  ia  made,  not  in  a  military,  but  a  physical  point  oC 
view,  to  show  more  generally,  what  every  physician  knows,  and 
all  the  world  should  know,  that  persons  may  be  surrounded  with 
poisonous  gasses,  without  being  conscious  of  them  through  the 
medium  of  any  of  the  senses.  Had  I  been  placed  two  weeks  un- 
der similar  circumstances,  it  is  presumed  the  unpleasant  efBuvia 
would  not  have  been  noticed  by  myself,  more  than  by  thoaa 
whose  sensitive  organs,  from  habit,  were  not  annoyed  by  theDU 


??'>•»,'    ..t 


"«(*?■;;!  /:     " 


V-'.     i.(.;..Jj  :  TJ   '■ 


':<■'■  ^,iv;;;     •    .  ir  ,-i';-i;  '*  \vy>\  w    > 


>    I 


f   ;..:.'  \. 


i.^f'  -  •>  ;.' 


r* 


N 


i 


1 


i;  I 


.'V.    I»l!^.,,  ■  '     -^:.    •/ 


.(■ 


>♦.« 


I 


i|!i!l 


I 

!•      , 

i.      ! 


^.. 


f  f!*:*!  ••• 


X 


•I  i 
1 


.   ,'1 V  i    ..■(       ■  '   •     '-  '  ■     '.  .  •  ; 

■1.1    •'••    ■  .    ';.  '  '   1  ,    ,ft»'t'»  J  »l  •»  ^».,'        •;.'»  ••  .,    ,.  I.  i  ,1  i    I,,  . 


.-»•■ 


SURGERY. 


.•  I'll  r.t'  n 

h  M »;*  i'l  


»i. 


AMPUTATIONS,   AND  CASES  OF  WOUNDS. 

The  opinion!  of  Labrcy,  chier«nrgeon  of  llie  imperial  guardijf 
ftod  inspector  general  of  the  niodical  itaff  of  tlie  French  armieB, 
respecting  amputations  and  gun-shot  wounds,  are  well  deserving 
the  attention  of  surgeons.  It  is  generally  believed,  they  are 
Correct,  and  with  some  exceptions,  should  be  adopted.  He  ob* 
serves,  "  when  a  limb  is  so  much  ii\jured  by  a  gunshot  wound* 
that  it  cannot  be  saved,  it  should  be  amputated  immediately.  In 
the  army,  many  circumstances  enforce  the  necessity  of  primi* 
tive  amputation."         i:7*:>,j  i  .'■■(.     .t:'.*m  -■ 

**  1st.  The  inconvenience  which  attends  the  transportation  of 
the  wounded  from  the  field  of  battle^o  the  military  hospitals  on 
bad  constructed  carriages. 

2d.  "  The  danger  of  remaining  long  iuliospital.  This  riaqm 
is  much  diminished  amputation ;  it  converts  a  gun-shot  wound 
5nto  one  w '^ich  is  capable  of  being  speedily  healed,  and  obviates 
the  causes  that  produce  the  hospital  fever  and  gangrene. 

*'  3dly.  In  cases  the  wounded  are  of  necessity  left  on  the  field 
of  battle ;  it  is  then  important  that  amputation  should  have  been 
performed,  because  when  it  is  completed,  they  may  remain  sev- 
eral days  without  being  dressed,  and  the  subsequent  dressings 
ajre  more  easily  accomplished.         :  .  .      •    '^        •  ■ 

**  The  necessity  of  primitive  amputation  is  enforced  by  state* 
meats  of  a  number  of  cases  illustrated  by  examples. 


X.  ii 


n   ! 


fiURGERT. 


cot 


CASE  riEST. 

**  Whea  B  limb  if  carried  away  by  a  ball,  by  the  bufBtihg  of  a* 
grenade  or  a  bomb,  the  moat  prompt  amputation  is  necessary. 
The  least  delay  endangers  the  life  oT  the  wounded.** 

After  the  battle  of  Lake  Champlain,  two  cases  or  this  discrip- 
tion  fell  under  my  observation.  A  simple  dressing  was  applied 
to  the  ragged  stump.  In  this  situation  they  were  brought  to  the 
hospital.  The  wounds,  having  the  appearance  oTbeing  dressed, 
did  not  call  'i\ir  first  attention,  when  many  presented,  which  re- 
quired an  imrkJdiate  operation ;  and  not  being  painAil,  were 
neglected  on  the  day  or  the  action.  The  follow  ing  morning  one 
was  round  dead,  and  the  second  having  been  exhausted  by  loss 
of  bk)od,  survired  amputation  only  a  few  houiv,  although  he  did 
not  loose  half  a  gin  of  blood  during  the  operation.  The  abive 
cases  might  have  been  saved  by  an  immediate  amputation.. 


CASE  SECOND.  * 

*'  When  a  body  is  projected  '-^m  a  cannon,  and  strikes  a  limb 
10  that  the  bones  are  fractured,  and  the  soft  parts  violently  con- 
tused, extensively  torn  and  broken  up,  amputation  should  be  in- 
itantly  performed.**  I  am  persuaded  that  several  of  the  above 
description  lost  their  lives  in  consequence  of  wounds  received 
by  the  explosion  of  the  magazine  at  Little  York,  who  might  have 
been  saved  by  immediate  amputation..  ••'  -l 


\4\\\ 


-i^  CASE  THIflD. 

"  When  a  targe  portion  of  the  soft  parts  and  the  principal  ves- 
sels of  a  limb  are  carried  away  by  a  ball,  and  the  bone  is  frac- 
tured, amputation  should  be  immediately  performed." 

CASE  FOURTH. 

**  When  a  large  ball  strikes  the  thick  part  of  a  Hrob,  breaks 
the  bone,  cuts  and  tears  the  muscles,  destroys  tiie  great  nerves, 
and  yet  leaves  the  principal  artery  entire,  immediate  amputation 
Should  be  resorted  to.  It  is  rendered  necessary  by  the  destruc- 
tion that  has  taken  place  in  the  limb,  and  by  the  coucussibiL 
tbt^t  has  been  given  to  the  whole  eubstauce.*' 


1  ) 

i 

ii 

1 ; 

1 

'       '[ 

1. ! 
■    '     5  I 


I  ^ 


T7^ 


w 


SURGERY. 


II 


r   r 


At  the  engagement  or  Plattsburgh,  Lieutenant  Dunean  or  the 
navy,  yiM  wounded  by  a  eaanoQ  baU,  which  passed  in  a  direc- 
tion of  the  acapulo-buraeral  articulation.  The  •uperincuiBl>ent 
muBcles  of  the  shoulder  with  part  of  the  Hibjacent  were  destroy- 
ed, leaving  a  amaU  portion  in  the  axilla  connected  with  the 
principal  artery,  which  received  no  iryury.  The  acromeon  pro- 
cess and  clavicle  were  fractured.  The  bead  of  the  humerus 
vrat  broken,  and  fonr  inches  of  its  substance  forced  away  by  the 
trail,  leaving  an  inch  of  its  extreme  head  attached  to  its  socket. 
In  similar  cases,  Larrey  recommends  immediate  an^)utatioB. 
From  the  destruction  of  the  parts,  my  opinion  was  that  to  save 
life  amputation  was  absolutely  necessary.  I  had  previously  read 
Iiarrey*8  statement  of  similar  wounds  cured  only  by  the  opera- 
tion ;  of  which  he  triumphantly  says,  "  the  truly  intelligent, 
bold  and  ''xpeiieoced  Kun  can  alone  know  and  appreciate  the 
wonderful  effects.**  Lieutenant  Duncan  objected  to  amputation, 
saying  he  bad  rather  lose  his  life  than  his  arm ;  the  loss  of  which 
lie  did  not  wish  to  survive,      via  jm  . ._ 

The  fractured  pieces  of  the  bones,  and  ragged  portions  of  the 
muscles  were  removed  by  th^  attending  surgeons,  Doctors  Brown 
and  Walker,  after  fae  was  removed  to  Burlington,  distant  twenty 
five  miles ;  by  attentive  and  careful  attentioa  to  his  wound  big 
arm  was  saved,  and  in  addition  to  appearance,  is  of  some  use. 

Two  >Younds  of  a  similar  description  were  received  from  can* 
uon  balls  by  two  seamen  of  Commodore  Macdonough's  fleet,  on 
the  eleventh  September,  1814,  in  Plattsburgh  bay  Upon  both  I 
applied  the  first  dressings.  Fragments  of  the  humerus,  clavicle 
and  acromion  process  adhering  to  the  lacerated  muscles  were 
removed,  as  well  as  such  puitions  of  the  muscles  as  appeared  to 
be  deadened  by  the  ball ;  the  end  of  the  fractured  humerus  which 
presented  itself  through  the  wound,  was  removed  as  low  as  pos- 
sible with  the  saw  ;  the  superior  extremity  of  the  humerus  which 
remained  in  the  socked  was  detached  by  dividing  itit  ligaatents. 
The  sound  muscles  which  remained  with  the  skin  were  secured 
by  straps  of  adhesive  plaster  in  as  close  contact  as  possible,  with- 
out giving  pain  ;  the  arm  was  permittett  to  retract  to  favour  this 
contact.      I^arge  sloughings  succeeded  for  some   considerable 


SUROERr. 


SM 


time ;  the  patientf  were  supported  nvith  a  soft  generoof  diet* 
wine  in  moderate  quantity  and  bark ;  and  eventually  recovered. 
A  maimed  arm  is  preferable  to  no  arm,  if  only  for  its  appear- 
ance. Where  the  loss  of  skin  is  as  extensive  as  the  wound,  and 
little  or  none  can  be  had  for  flaps,  the  cure,  in  the  above  in- 
stance was  nearly  as  soon  effected  as  it  would  have  been  had 
amputation  been  performed.  Larrey  exults,  that  by  the  operation 
nine  cases  out  of  ten  will  succeed. — But  it  will  be  understood,  a 
loss  of  a  limb  and  consequent  deformity  succeeds.  Whereas  I 
am  convi.  ^d  that  ten  out  of  ten  may  be  cured,  where  the  pa- 
tients have  good  health ;  the  limb  saved,  with  the  small  deform- 
ity of  a  too  sudden  sloping  of  the  shoulder,     f  ,,  ,  -    ,.  %,  r-      ^ 

.1     i     ,         V     .  CASE  FIFTH. 

"  If  a  spent  or  a  rebounding  ball  strikes  a  limb  obliquely,  with- 
out causing  a  solution  of  continuity  in  the  skin,  as  often  happens, 
the  parts  which  resist  its  action,  such  as  the  bones,  the  muscles, 
tendons,  the  aponeuroses,  and  the  vessels  may  be  broken  and 
torn.  The  extent  of  the  internal  injury  must  be  ascertained, 
and  if  the  bones  be  fractured  under  the  soft  parts,  and  if  there  be 
grounds  to  suspect  the  vessels  are  lacerated  (which  may  be 
known  by  the  enlargement,  and  a  kind  of  fluctuation)  araputar 
tion  should  be  performed  without  delay.  But  sometimes  the  ves- 
sels and  the  bones  have  been  spared,  and  the  muscles  alone  have 
been  totally  disorganized.  Then  an  incision  should  be  made  in 
the  skin ;  by  this  means  the  thick,  black  blood  may  be  permit^ 
ted  to  escape,  and  the  consequences  may  be  predicted.** 


1 


t  • 


<i< 


ri 


!  : 


CASE  SIXTH. 

"  When  the  bursting  of  a  bomb,  or  the  stroke  of  a  ball  has 
fractured  the  orbicular  extremities,  more  particularly  those  which 
form  the  knee,  or  the  ankle  joints,  and  when  the  ligaments  which 
surround  these  articulations  have  been  torn  or  broken  up,  imrae- 
diate  amputation  becomes  indispensably  necessary.  The  same 
indications  will  present,  if  the  foreign  body  bury  itself  in  the 
thickest,  part  of  one  ef  the  orbicular  extremities.'* 


111 

lllti., 

HI  i  M 

!  I; 


M 


:    frr 


{m 


h:\ 


li  •!  ■■ 


11 

i! 


2ia 


gUftiGBRT. 


Doctor  Hall,  the  translator  or  the  works  of  Larhgt,  fs  oppo^ 
sed  to  \m  last  opinion,  and  says  "  this  advice  should  not  be  Tol* 
lowed  in  all  oases  ;  where  the  ball  is  made  of  lead,  and  is  no 
larger  than  a  musket  ball,  it  may  remain  many  years  in  the  joint, 
and  perhaps  during  life,  without  causing  much  inconvenience 
after  the  first  symptoms."  The  observation  of  Doctor  Hall  we 
believe  correct.  Wounds  made  by  musket  balls  through  the  ar- 
t?<;ular  extremities  have  been  cured  without  the  loss  of  the  limb. 
Besides  there  can  be  no  inconvenience  or  hazard  of  life  by  at> 
tempting  a  cure,  compared  with  the  certain  loss  of  the  limb.  A 
patient  is  willing  to  submit  to  extrer  ^  distress  for  the  sake  of  a 
limb,  if  there  is  a  distant  prospect  of  saving  it. 

CASE  SEVENTH.  "  *     '    '  '' 

**  Has  a  ball  or  the  fragment  of  a  bomb  passed  through  a  limb, 
and  denuded  a  large  portion  of  its  bone  without  fracturing  it? 
In  this  case,  although  the  soft  parts  nay  appear  as  if  they  might 
be'  saved,  yet  amputation  is  not  less  indicated.  Yet,  before  a 
decision  be  made,  all  t  '  symptoms  should  be  attentively  con^ 
sidered."        "e  ,'H}';:'"*!  5  5*  *  i«'a  .ij4^*e>«  :K"-3ia04«i-^>t'-iJ  W4 

It  is  believed  the  above  case  seldom  requires  amputation  in 
the  first  instance,  especially  where  the  ball  is  no  larger  than  one 
projected  from  a  musket.  It  is  more  advisable  to  wait,  and  be 
governed  by  consequences;  and  d.pend  upon  consecutive  am« 
putation  if  necessary.       -^    -      -.      „  _,     , 


CASE  EIGHTH. 


■n:,h. 


Larrey  "  adds  another  case  in  which  primitive  amputation  is 
requisite  ;  that  is,  when  a  great  ginglymoid  articulation,  such  as 
the  elbow,  and  especially  the  knee  is  opened  by  a  cutting  instru- 
ment  to  a  great  extent,  and  a  sanguineous  effusion  takes  place  in 
the  joint.  In  these  wounds  the  synovial  membrane,  th6  liga- 
ments, and  the  aponeuroses  inflame  from  the  injury  received  and 
the  contact  of  the  air.     '''}&^mymmy.  m>i^m^>  iHAUs^mm^^mM 

**  Tumefaction  and  erethismus  of  the  parts  soon  ensue,  and  acute 
pain,  abscesses,  deep  fistulas,  caries,  fever  from  absorption,  and 
death  follow.    I  have  seen  a  great  number  perish  from  this  spe- 


.!  1 


■^ 


SURGERY. 


211 


tiies  of  wound*,  beeauie  the  operation  has  been  postponed  from  a 
hope  that  the  limb  might  be  preserved." 

Doctor  Hall,  the  translator,  does  not  admit  as  conclusive  eV' 
idence,  the  necessity  of  amputating  when  large  joints  are  wound- 
ed, or  the  cases  adduced  by  Larrey,  "  one  was  brought  to  the 
hospital  two  days  after  he  was  wounded ;  and  in  the  second,  the 
soldier  walked  two  miles  after  having  the  knee  opened  by  a  sa- 
bre. Is  it  then  surprising,"  adds  Doctor  Hall,  *'  that  fatal  in- 
flammation should  ensue,  where  p'  '  os,  every  necessary  cause  is 
combined  to  produce  it  ?  What  d  have  been  the  result  in 
these  cases,  if  their  wounds  had  received  immediate  surgical  at- 
tention in  the  comfortable  and  temperate  wards  of  a  hospital  ?"  ^ 

A  soldier  of  the  33.d  regiment  was  admitted  into  the  hospital 
at  Burliqgton,  having  received  a  wound  through  the  knee.  The 
ball  entered  at  the  external  condyle  of  the  femur,  just  under  the 
qpper  edge  of  the  patella,  and  passing  obliquely  downwards  and 
backwards,  made  its  exit  where  the  inner  condyle  meets  the 
tibia.  Amputation  was  pro;5osed.  This  was  olyected  to  by  the 
patient.  Six  weeks  after,  this  case  came  under  my  observation. 
The  integuments  of  the  knee  joint  were  extremely  swollen,  the 
swellii^  extending'up  to  the  trunk.  The  leg  and  foot  were  en- 
larged and  sedematous ;  pus  mixed  with  synova  issued  from  the 
wound.  Upon  examination,  a  sinus  extended  from  the  external 
Qtpening  up  under  the  muscles  of  the  thigh,  also  between  the 
muscles  and  femur  on  the  internal  and  posterior  parts.  The 
capsular  ligament  appeared  to  be  thickened  and  distended  with 
matter.  The  patient,  extremely  emaciated,  had  suffered  ex- 
ceedingly from  pain.  Amputation  was  again  proposed,  buthis  first, 
resolution  was  still  adhered  to.  The  sinuses  were  laid  open  up 
from  the  external,  and  from  the  internal  wounds ;  and  a  more 
depending  opening  was  made  on  the  back  part  between  the  two 
openings.  A  spiral  bandage  was  applied  upon  the  limb  from  the 
foot  to  the  trunk.  .  Afler  ten  days,  the  discharges  from  the  sinu- 
ses lessened ;  the  swellings  throughout  the  thigh  and  leg  had 
much  abated ;  the  wounds  assumed  a  belter  appearance.  Final- 
ly, they  healed  and  the  limb  was  saved,  but  with  a  stiff  joint.  .  f 

The  above  wound  not  made .  by  a  cutting  io8trumeM>  was  . 


Ill  i 


i  if 


I 


r 


•i 
hi 


Mm  n 


i\\ 


I  n 


"T 


1-^ 


It     ip^ 


212  SURGERY. 

more  hszardoin.    The  ease  demomtrates  that  La&rcy  tvas  too' 
precipitate  in  making  up  his  opinion. 

The  following  case  b  similar  to  the  fast  position,  tvliereiB 
Larrey  recommends  immediate  amputation.  A  soldier  receiv* 
ed  a  sabre«wound  on  the  knee,  vrhich  divided  the  common  ten- 
don of  the  extensors  of  the  leg,  near  its  union  iivith  the  patella, 
obliquely  downwards.  The  patient  was  immediately  put  into 
bed,  his  leg  extended,  was  largely  bled,  purged,  and  put  on  a 
Tegetable  diet.  The  lips  of  the  wound  were  immediately  brought 
into  apposition  by  straps  of  adhesive  plaster.  This  wound  was 
cured  by  the  first  intention  without  suppuration* 

In  many  cases  it  is  diflScult  to  determine,  most  correctly, 
whether  it  is  best  to  amputate  immediately,  or  defer  it,  to  see  if 
the  limb  may  be  saved— ^and  if  it  oannot  be  saved,  to  operate  at 
a  future  period.  When  an  opinion  is  formed  that  the  chance  of 
saving  a  limb  is  greater  than  the  risque  of  losing  life  by  defe^ 
ring  an  amputation  until  an  experiment  is  made  to  save  it — to 
defer  the  operation  is  proper. 

While  taking  this  into  consideration,  due  weight  should  be 
given  to  all  the  circumstances  which  may  tend  to  promote,  re- 
tard, or  prevent  a  cure.  '•  ' 

When  a  case  is  of  such  a  nature  as  would  render  a  cure  dubi- 
ous under  the  best  attendance,  and  most  eligible  situation— <if 
circumstances  do  not  admit  of  these,  the  operation  should  not  be 
deferred ;  because  a  case,  which  is  doubtful  in  the  first  instance, 
becomes,  from  unfavourable  circumstances,  not  only  hazardous, 
but  fatal,  under  their  influence. 

The  circumstances,  which  might  determine  the  chances  fkr- 
ourable  and  unfavourable,  are  many  and  various. 

Where  the  wound  is  extremely  hazardous  from  its  nature,  and 
the  patient  must  be  necessarily  exposed  to  cold,  wet,  bad  diet 
and  lodgings ;  to  defer  amputation  would  be  certain  death ;  be- 
cause the  only  chance  for  life  would  be  to  render  his  condition 
more  comfortable  by  removing  a  part  of  the  causes  which  enfee- 
ble life,  that  life  may  be  supported  SG  as  to  overcome  the  re- 
maining causes  which  endanger  life.  '      '     '1 


SURGERY. 


218 


When  a  wdumi,  which  may  require  amputation,  is  in  Us  nar 
Lure  dubious,  under  all  the  comrorti  of  life ;  if  received  when  un- 
der a  state  of  debility  from  bodily  inlirnlities,  the  only  chance 
will  be  to  remove  the  linab  immediately.  ,     ,.,,,., 

When  a  wound,  which  may  require  amputation,  h  received, 
nnder  an  epidemic  state  of  atmosphere,  or  when  an  infectious 
disease  prevails ;  to  defer  the  operation  would  deprive  the  pa- 
tient of  every  chance  of  life. 

The  above  observations  are  particularly  applicable  to  field 
practice. 

Although  there  are  cases  which  require  immediate  amputation 
on  the  field  of  brittle,  and  without  which  life  cannot  be  saved; 
yet  we  have  to  observe,  that  after  (he  battles  of  Little  York  and 
Fort  George,  a  less  number  survived  primitive  than  consecutive 
amputation.  From  reports  it  was  understood,  that  three  or  four 
died  immediately  after  the  amputation  was  performed  on  battle 
ground ;  whereas  there  was  not  a  single  case  of  death  during  the 
campaigUj  after  consecutive  amputation,  occasioned  by  this  op- 
eration. 

Several  amputations,  performed  immediately  after  the  firf>t 
symptoms  were  passed,  were  followed  \\,ith  success.  Three 
were  made  by  myself  between  five  and  seven  weeks  after  their 
wounds  were  received,  all  of  whom  recovered.  The  amputa- 
tion of  these  was  delayed  in  the  first  instance,  in  expectation  of 
saving  the  limb ;  but  unavoidable  exjiosures.  On  board  transports^ 
to  wet,  and  motion  of  the  vessels  during  a  storm  of  several  days, 
rendered  am|)utation  necessary  after  the  wounded  were  landed 
on  the  Niagara.  I  also  performed  an  amputation  at  Lewistown» 
uiK>n  a  Canadian  volunteer,  belonging  to  the  corps  of  Colonel 
WiiiCox,  twenty-one  days  after  the  wound  was  received,  with 

success.  rri'/.      ■','/   *■::■■    ,{  \    ;  ',  ■■■■■.      . 

.  A  musket  ball  shattered  the  femur  about  five  inches  below 
the  great  trocanter.  This  man  remained  with  his  corps  and  was 
attended  by  its  surgeon,  until  the  rlay  previous  to  the  operation;, 
when  hfe  was  received  into  the  hospital  at  Lewistown,  extreme- 
ly emaciated  and  debilitated^,  with  total  loss  of  appetite.  Sinu- 
ses were  formed  down  the  thigh  its  whole  length ;  the  leg  waa 
also  extremely  swollen  and  «ederaatous.  In  order  to  avoid  a  »i- 
28 


i 

i 

T 

i': 

1 

1 

il 

iji 

1     : 

li|i 


i,  h 


11 


1 

4\ 

M:  II 


'1  ';7  V 


214 


SURGERY. 


n 


nus  running  up,  the  amputation  was  made  as  near  the  trunk  as 
possible.  The  first  six  days  his  case  was  doubtful.  In  conse* 
t]uemce  of  great  distention  of  the  lymphatics,  large  discharges 
from  their  open  mouths,  followed  the  operation  a  number  of  days. 
"  ^ter  which  his  appetite  was  restored ;  the  wound  was  entirely 

jaled  in  five  weeks. 

I  performed  an  amputation  in  a  similar  case,  at  Plattsburgh, 

upon Williams,  a  soldier  of  the  10th  regiment  from 

Virginia.  This  man  was  admitted  into  the  hospital  twenty- 
three  days  after  the  wound  was  received.  The  ball  fractured 
the  femur  half  way  between  its  articulation  with  the  tibia  and 
the  great  trocanter.  The  thigh  and  leg  were  much  enlarged ; 
an  edematous  swelling  extended  to  the  groin.  Sinuses  were 
formed  through  the  muscles  of  the  thigh  in  all  directions — so 
that  it  was  necessary  to  make  the  amputation  as  near  the  trunk 
as  possible ;  and  then  it  was  discovered  that  a  sinus  continued 
up  above  the  place  of  incision.  This  man's  ivound  healed  com- 
pletely, and  he  was  on  his  crutches  in  sixteen  days  after  the  op- 
eration. 

When  a  wound  is  of  such  a  nature,  that,  from  the  first,  no  cure 
mny  be  calculated  upon,  no  delay  for  the  first  symptoms  to  pass 
off  should  be  admitted ;  an  amputation  should  be  immediately 
performed.  It  is  acceded  to  by  all,  that  the  primary  symptoms  of 
a  wound,  which'requires  amputation,  are  more  severe  than  those 
which  succeed  primitive  amputation.  Wherefore  nothing  is 
gained  by  waiting  until  the  primary  symptoms  are  over,  but 
much  is  hazarded.  The  patient,  convinced  that  amputation  is 
necessary  to  preserve  his  lil^,  has  less  hesitancy  to  the  immedi- 
ate operation,  than  the  consecutive  when  it  becomes  necessary. 

I  have  seen  cases,  where  an  amputation,  performed  immedi- 
ately after  the  wound  was  received,  might  have  saved  life ;  and 
where  the  same  limb  might  have  been  preserved  by  suitable 
means ;  and  life  eventually  lost  by  neglect  of  proper  manage- 
ment. Instances  like  these  should  not  be  brought  as  examples 
to  demonstrate  that  delay  was  improper ;  they  show  the  neces- 
sity of  applying  the  means  of  cure  most  assiduously ;  and  where 
these  means  are  not  at  command,  no  delay  of  amputation 
should  be  permitted. 


m 


SURGERY, 


215 


Larrey  mentions  four  caset  where  consecutive  amputatitu  it> 
required.  "     ^^,,  :.rV:"„.'> 

.'•3.:>    ;■..-  >■;   ';M'i   '■...      CA8E  riRST.  '^  ^    -■,{.'■(  .1  ;„.   :%  •' 

When  there  is  mortification  on  a  limb ;  "  if  gangrene  be  trau^ 
matic,  no  time  should  be  lost  in  removing  it  above  the  sphace- 
lated  part  The  amputation  will  succeed,  when  the  deleteri- 
ous principle  has  not  been  copiously  absorbed.  There  are  ma* 
ny  facts  to  support  the  doctrine."       ,  ,      .,    .     .,    ..  ,,  ,  . 


EXAMPLE. 


•V  ihia 


Report  of  a  Case  of  Amputation,  by  J.  B.  JfHJTRIDGEy  M.  D. 
Hospital  Surgeon's  Mate,  non  a  resident  in  Clmrleston,  Souths 
Carolina. 

*'  Sir — Permit  me  to  offer  you  the  following  report  of  the 
case  of  James  Parker,  of  the  13th  regiment  United  States'  In- 
fantry^ belonging  to  Captain  Paige's  company ;  who  was  wound- 
ed at  Sandy  Creek,  and  received  into  the  general  hospital  at 
Sackett's  harbor,  on  the  11th  of  June,  1814.  ,y  , ;,'.     .      ,.; 

"  This  patient  was  wounded  about  six  days  previous  to  his  be- 
ing sent  to  the  hospital,  and  received  little  or  no  treatment  dur- 
ing that  time,  not  even  the  common  attention  of  nursing ;  of 
consequence  his  case  was  a  very,unfortunate  one. 

"  I  feel  peculiarly  interested  in  this  case,  as  it  is  the  only  fatal 
case  of  simple  amputation,  which  has  occurred  to  me  in  the 
course  of  an  extensive  surgical  practice,  during  the  present  war. 

"  A  common  musket  bull,  of  nearly  one  ounce  weight,  and 
three  buck  shot,  entered  upon  the  inside  of  his  right  leg,  near  the 
edge,  and  at  the  superior  portion  of  the  gastrocnemius  muscle. 
They  passed  in  a  direction  obliquely  upward,  through  a  portion, 
both  of  the  tibia  and  &bula ;  the  ball  and  two  shot  made  their 
exit  at  the  articulation  of  those  two  bones ;  extending  the  frac- 
ture into  the  articulation  of  the  kaee  joint.  ,  <{ 

"  The  fracture  was  very  extensive,  and  several  large  portions 
completely  detached,  while  a  large  mass  of  the  bones  were  re- 
duced to  very  small  fragments,  approaching  even  to  powder. 

"  When  this  patient  was  received  into  the  general  hospital, 
from  Sandy  Creek,  transported  by  land,  a  distance  of  eighteen 


1 


I  I 


, 


I- 


'I 


;l) 


i  i  i 


■^'1: 


IN 


I  l;  /  ', 


210 


SURGERY.  ! 


l^ 


^ 


miles,  his  leg  wns  in  a  state  oT  comiilete  sphace]at!oD,  na  high  ai 
the  wound.  •  ",    > 

"  From  a  history  of  llie  case,  It  appeared  that  there  had  been 
mnch  hemorrhagy  from  the  vroiind  in  the  first  instance,  and  dur- 
ing the  first  day  of  the  acciiiont ;  from  this  circuinatancr,  and 
from  the  course  of  the  ball,  it  is  probable  the  peroneal  artery,  or 
perhaps  the  tibialis  postica,  was  wounded  ;  which,  however,  was 
not  particularly  demonstrated  after  tlie  operation. 

"  On  the  first  day  after  his  reception,  carbonic  acid  gas,  was 
applied,  in  the  form  of  a  fermenting  cataplasm  to  tlie  whole  limb. 
Baric,  (cine,  ofls.)  wine,  and  opium  were  given  him.  The  eve- 
ning following,  a  tinct.  meloes  vesicat.  was  applied  to  the  gan- 
grenous |)art,  and  the  fermenting  cataplasm  re-applied  over  the 
whole,  with  the  hope  of  restoring  the  heat  and  circulation  ;  but 
In  vain ! — The  barlt,  wine,  and  opium,  and  the  fermenting  poul- 
tices, were  continued  until  4  o'clock  the  day  following ;  when  a 
consultation  was  called.  Four  hosnitul  surgeons,  and  a  number 
of  other  medical  gentlemen,  both  of  the  army  and  navy,  being 
present,  (from  the  declension  of  his  health,'^  and  urgency  of  the 
symptoms,)  an  immediate  amputation  was  agreed  on,  though 
under  circumstances,  not  the  most  favorable. 

**  The  inHammation  and  swelling  about  the  knee,  and  along 
the  muscles  of  the  thigh,  having  measurably  abated,  and  the 
progress  of  the  mortification  being  checked— circumstances,  which 
^vere  thought  to  warrant  the  operation  ;>  the  lim'i  was  amputa- 
ted about  five  inches  above  the  knee  joint ;  the  skin  below  the 
place  of  operation,  having  a  somewhat  Hvid  appearance. 

**  The  whole  thigh  still  considerably  swollen,^  and  the  integu- 
ments and  muscles  very  rigid.  After  the  integuments  were  di- 
vided, and  the  flap  dissected  up  with  a  scalpel,  the  swelling  and 
rigidity  were  such,  that  it  was  with  much  difficulty  reflected. 

"  It  is  remarkable  in  this  case,  that  the  muscles  when  first  dit 
yided,  shew  very  Httle  disposition  to  retract. 

*  See  Dorset's  Surg.  Vol.  2d.  p.  ?46.  .:»,..  ,-  • 

*  YMe  Mr.  C.  Bbil's  Oper^t.  Surg.  Vol,  1  at.  p.  2T0, 


1 


SURGERY. 


217 


*'  I  performed  this  operation  hj  tlie  triple  incision,  (something 
in  the  style  of  the  celebrated  M.  Loui8,t  a  French  surgeon,)  in 
the  manner  mentioned  l>y  Mr.  S.  Cooper^  and  recommended  bj 
Doctor  Warren,  jun.  of  Boston. 

"  Very  little,  however,  was  gained  by  (his  complicated  mode 
of  operation  in  this  particular  case.  The  superficial  muscles, 
though  first  divided,  retracted  so  li'Me,  that  perhaps  not  more 
than  a  quarter,  or  three  eights  of  an  inch  was  gained  by  this  sec- 
ond incision :  by  the  third  incision  the  dee[)  seated  muscles  were 
divided,  and  (he  retractor  applied  without  much  effect,  in  conse< 
quence  uf  the  inflammation  and  swelling  of  the  muscles,  at  the 
place  of  operation.  .,;..,,.  

"  The  bone  was  sawed  as  high  as  possible,  with  the  ordinary 
retraction ;  this,  however,  was  very  little  above  the  division  of 
the  deep  seated  muscles. 

**  After  the  ligatures  were  made  upon  the  bloo<1  vessels,  the  edg- 
es of  the  wound  were  placed  in  contact,  which  fit  very  neatly  to- 
gether, so  as  to  form  only  a  longitudinal  line  ;  and  secured  in  that 
situation  by  adhesive  plaster.  The  stump  was  then  dressed,  and 
the  patient  placed  in  bed.  He  rested  very  well  the  night  follow- 
ing, and  appeared  to  be  very  much  relieved  by  the  operation. 

"  The  local  arterial  action  for  the  first  two  or  three  days  after 
the  operation,  was  inconsiderable ;  but  the  general  action  some- 
thing above  the  healthy  standard ;  so  that  he  would  bear  no 
stimulus  above  his  ordinary  food,  and  for  that  he  had  not  much 
appetite.  ; 

"  On  the  fourth  day,  in  consequence  of  the  bandages  becom- 
ing foul,  it  was  thought  advisable  to  dress  it.  On  removing  the 
dressings,  it  was  observed,  although  the  lips  of  the  wound  were 
perfectly  in  contact,  no  union  of  any  consequence  had  taken 
place.  As  soon  as  the  adhesive  straps  were  removed,  the  lips 
of  the  wound  fell  immediately  asunder :  no  granulations  had 
formed ;  suppuration  had  not  taken  place ;  the  muscles  were 
shrunk  and  contracted,  and  had  assumed  a  pale  and  almost  col* 


I    1 


m'l. 


.  t 

1 

'  1 

. 

ji, 

1   1 

t 

i 

1 1 

t  For  his  method  consult  Mem.  de  I'Acad.  de  Chirnrgic. 
I  Sec  Cooper's  First-Lines,  p.  426. 


!  ■'  h 


i 


£18 


SURGERY. 


y 


HJU) 


. 

J  ,. 

t  • '  r 

! 

i. 

L. 

.ourless  appearance;  but  which  was  pre-eminently  thecaieat 
the  subsequent  dressings.  There  seemed  to  be  a  want  of  action 
in  the  par'** ;  as  it  afterwards  ap^teared,  there  was  not  action 
sufficient  to  excite  adhesive  inflammation.*  .mri./tvT'<*(7  m^jim 

*'  By  the  medical  gentlenion  present,  this  first  dressing  wan 
thought  premature :  had  it  not  been  dressed  so  soon,  perhaps  ad- 
hesion might  have  talcen  place.  The  parts  were  then  placed  in 
contact,  and  the  dressings  applied  as  before.  Cine.  ofi*.  was 
administered  in  as  large  quantities  as  the  stomach  would  bear. 
As  much  wine  was  given  as  the  patient  could  be  made  to  take» 
and  occasionally  a  few  draps  of  the  tinct.  opti. 

"  By  the  advice  of  the  faculty,  the  dressings  were  not  again  re- 
moved until  the  Aiird  f  day  following ;  at  which  time  it  had  be- 
come very  foul.  On  remov'  ^g  the  adhesive  straps,  it  appeared 
no  union  had  taken  place ;  the  lips  of  the  wound  fell  immediate- 
ly apart  as  before  :  no  granulations  had  taken  place  from  the  bot- 
tom, and  very  little  suppuration.  The  muscles  had  contracted 
still  more,  ai>d  left  the  bone  quite  bare;|  they  were  shrunk  and 
pale,  and  indicated  a  total  waqt  of  action.  The  stump  was  thor- 
oughly washed  with  a  strong  solution  of  soap.  Bark  in  powder 
was  then  introduced  in  large  quantities,  into  every  part  of  the 
wound,  to  endeavour,  by  its  co-operation  with  the  stimulus  of  the 
soap,  to  excite  it  into  action.  The  parts  were  then  place  -  io 
contact,  and  the  wound  dressed  as  before. 

*'  At  this  time  diarrhoea  supervened,  which  occasioned  the 
use  of  an  additional  quantity  of  the  tine.  opii. 

"  The  anorexia  and  debility  increased.  Nourishing  food  was 
given  him — such  as  rich  soup,  milk  porridge,  panada,  &c.  in  such 
quantities  ^,s  he  could  be  made  to  take.  Bark,  wine,  and  lauda- 
num were  also  continued  in  large  quantities.  )->r.vffo»  ui\'.U)^'.'vi 

*' Tuesday,  the  21  st.  It  was  dressed  as  before:  medicines 
continued — had  the  patient  sponged  all  over  with  St.  Croix 
ram,  and  the  stump  frequently  wet  with  it — substik  "ted  milk- 
puncb,  instead  of  wine  for  common  drink.    The  patitat  now  be- 

»  See  Bell's  Operat.  Surg.  vol.  1st,  p.  246.     ;,v.:  • ,,-  , . .  •„;  1 ' 
t  See  Dorsey's  Surg.  vol.  2il.  p.  251.  :  t/n. 

X  Vide  Bell's  Operat.  Surg.  vol.  1st.  p.  290,  Amer.  E&  .    , 


T^ 


SURGERY. 


21d 


came  lomeii^hat  lethargic  and  ttupid,  with  a  slight  diieccea. 
Though  restUss  and  uneasy,  from  the  time  of  the  operation,  com- 
plained of  It.)  |>ain  t:i  his  leg,  but  pain  in  his  Iwcic  and  hips  Trom 
fatigue  of  lying,  and  would  frequently  roll  from  side  to  side,  re- 
gardless of  the  stump ;  instead  of  resting  it  on  the  pillow  upon 
which  it  was  placeil,  would  suffer  it  to  hang  without  any  support^ 
or  lie  any  way  he  happened  to  turn.       •''  i-  -nl'  .  'icmKli'  •• 

'*  Wednesday,  22d.  Though  the  integuments  covered  the  bone 
handsomely,  the  muscles  had  retracted  so  much  that  it  was  evi- 
dent a  cure  could  not  be  effected  without  a  removal*  of  a  portion 
of  the  bone,  either  by  a  natural  or  artificial  process.  The  pro* 
cess  of  exfoliation  is  so  tedious,  that  it  was  thought  advisable,  to 
remove  it  by  means  of  the  saw.  The  crurcus  muscle  was  re<di- 
vlded  by  the  scalpel.  Not  apprehending  any  difficulty  from  the 
hemorrhage  of  the  blood  vesaeis  of  this  small  muscle,  though  pro- 
vided  with  a  tourniquet,  I  did  not  take  the  precaution  to  apply 
it,  until  reduced  to  that  necessity  by  the  hemorrhagy.  A  re- 
tractor was  then  placed  on,  and  by  powerful  retraction  1  was  en< 
ablcd  to  remove  an  inch  and  a  quarter  of  the  os  femoris. 

"  I  proceeded  to  secure  the  blood  vessels :  they  were,  however, 
80  small,  and  the  muscular  fibres  so  tender,  that  they  could  not 
be  taken  up  by  the  tenaculum.  I  passed  a  needle  round  a  plex- 
us of  vessels  which  appeared  to  bleed  moat,  without  having  much 
effect  upon  the  hemorrhagy.  I  passed  it  round  a  second  and 
a  third  time,  without  completely  restraining  it.  It  appeared  to 
bleed  from  the  whole  surface  of  the  <'lvided  muscle. 

*'  The  fact  was,  the  debility  of  the  divided  muscle,  and  the 
parts  adjacent  was  such,  that  there  was  not  sufficient  power  in 
the  blood  vessels  to  retract  themselves.  The  blood,  though 
probably  oozing  from  minute  branches  of  arteries,  appeared  to  be 
completely  deoxygenized,  and  had  the  appearance  of  venous 
blood. 

"  The  stimulus  of  cold  was  not  alone  sufficient  to*  produce 
that  contraction  necessary  to  restrain  the  hemorrhagy.  I  there- 
fore applied  cold,  undiluted  spirits,  which  immediately  produced 


■  I 


I  !» 


See  Mr.  C.  Bell's  Operative  Surg.  vol.  l6t.  p.  263, 264,  and  290. 


I 


t20 


ftURGERY. 


1 '      » 


i  Mh 


a  retrtctiaa  of  (he  veaaels,  and  Ihe  hemorrbago  ceaaed.  Tlt«^ 
■tump  wai  then  waaheil  all  over  with  apirita,  and  dreaaed  as  lie 
fore.  Milk-punch  waa  given  him  freely,  and  the  whole  bodj 
■imnged  with  rum  three  or  four  timea  in  the  courae  of  the  day. 
The  anorexia  and  debility  increaaed,  puiac  quick,  arofill,  and  fre 
queot.     Bark,  wine,  and  laudanum  continued.     .Ui  u,.'*  i*  .(  r  ' 

*'  Thuraday,  the  23d.  No  action  hud  taken  place;  the  atumi^ 
waa  dresaed  aa  before.  The  aame  treatment  continued,  with  the 
greateat  possible  energy.  The  patient  became  more  comatose  { 
the  diaecoBa  increaaed,  and  all  those  aymptoma supervened  which 
are  the  precuraors  of  death. 

*'  He  aurvived  until  about  one  o'clock  in  the  rooming  of  the 
24th,  when  the  cold  and  pallid  hand  of  death  viaited  him,  which 
terminated  the  tragic  scene !" 

"  With  sentiments  of  esteem,  and  the  highest  respect, 
your  very  humble  servant, 

J.  B.  WHiTRIDGE.^' 

Dr.  JAMEt  Manw,  Ho*.  SMr^€on.         >  i      i 

^'SackctCs  Harbour,  June  2%ih,\Z\A.'* 


:'.)■! 


The  following  cases  of  gun-shot  wounds,  where  the  opeAition 
was  delayed  to  preserve  the  limbs,  and  a  consecutive  amputa- 
tion became  necessary,  is  here  detailed  at  full,  as  reported  by 
hospital  surgeon's  mate,  March,  to  show,  that  in  similar  cases, 
immediate  amputation  should  be  made ;  as  well  us  to  describ-j 
the  feelings  of  a  young  surgeon,  when  performing  his  first  am|>u< 
tion. 

"Jacob  Blutit,  a  private  inCapt.  Van  Vechten's  company, 
23d  regiment,  24  years  old,  in  the  action  at  Sackett's  Harbour, 
29th  May,  1813,  received  a  grape-shot  in  his  leg,  which  shatter- 
ed the  tibia  and  fibula.  It  soon  inflamed  and  became  much 
swollen.  Clolhs  wet  with  diluted  spirits  were  continually  ap- 
plied.  By  thv;  fourth  day  the  limb  was  so  much  swollen  as  to 
induce  Doctor  Trowbrid^c  to  make  several  incisions  through 
the  integuments,  from  just  below  the  knee  to  the  ancle.  Af 
this  time  mortification  had  considerably  progressed.  The  leg 
assumed  a  mixed  colour  of  yellow  and  purple ;  the  cnticiila  >Ya!« 


SURGERT. 


221 


t&UcA  In  smnil  blisters.  The  Irt;  and  IhiKit  vrcre  contlnualljr 
wet  with  told  rum  nnd  watrr,  until  the  tenth  oT  June,  when  the 
mortincntion  hnd  censfd.  Innairtmation  hud  disappeared  from 
both  le;;  and  thiKh  so  munh,  that  an  amputation  was  determined 
U|>on.  U|K)n  the  lllh  of  June  I  performed  the  operntion  in  the 
following;  rannner  just  above  the  knee.  I  gave  the  patient,  30 
minutes  before  the  operation  was  commenced,  two  j^rains  of  opi- 
um, when  he  was  placed  on  a  hi^h  table.  After  the  a|);dica- 
tion  of  the  tourniquet,  Docttor  Trowbridoe,  my  operative  as- 
sistant, grasped  the  thigh  with  l)oth  hands,  and  kept  the  integ- 
uments steady,  while  the  first  incision  was  m;ide  down  to  the 
fascia  {  ofter  which  he  retracted  the  integuments  as  much  an 
possible,  while  1  dissected  tiiem  up  from  the  muscles  with  a  scal- 
pel. Having  dissected  the  skin  with  the  cellular  substance  about 
an  inch  and  half  up,  and  turned  them  back  on  the  thigh,  at  this 
point,  I  made  a  second  incision  with  a  steady  and  firm  stroke 
of  the  knife  around  the  thigh  down  to  the  bone.  [Note.  It  re- 
quires considernble  strength  and  firmness  to  carry  the  knife 
through  the  thick  musclos  and  firm  tendons^  at  one  stroke.  If 
we  are  not  aware  of  this,  we  shall  fail  in  our  first  attempt.  At 
the  moment  the  incision  is  made,  the  vl..jus  and  arterial  blood 
gushes  out  in  such  torrents,  as  to  alarm  the  young  surgeon,  per- 
forming his  first  amputation,  fearful  that  the  tourniquet  waa 
not  sufficiently  secur?.  But  soon  I  found  the  blood  t8sue<l 
from  the  veins  and  arteries  below  the  incision,  when  apprehen- 
sion of  danger  ceased.] 

"  The  muscles  being  divided  down  to  the  bone,  the  operative 
assistant  applied  the  retractor,  made  of  new  strong  lineU)  (pref- 
erable to  leather,)  and  drew  back  the  divided  muscles,  while  I 
dissected  the  mupcles  from  the  bone  one  inch  or  more,  when  the 
bone  was  divided  with  the  saw,  and  arteries  taken  up  with  the 
tenaculum.  In  this  case  they  were  five  ;  more  in  number  thaa 
usual.  After  sponging  the  stump  with  warm  water  to  clear 
away  the  clotted  blood  to  search  for  other  bleeiling  vessels,  and 
finding  none,  I  turned  down  the  integuments  over  the  stump,  and 
secured  them  in  apposition,  with  strips  of  tidhesive  plaster,  and 
tiressed  in  the  usual  method.  '.  -f 

29 


I     I 


4 

1 

II 

''  [ 

i 

' 

1 

'» 

: 

(  ^ 

4 

A ' 

i 

1 

*      i 

( i 

5   1 

11    1 

i 

; 

W|W    '  ■■— '■ 


222 


SURGERY. 


11    I 

1 


Ai. 

:.    it  :f» 

i     i  r  J'l 

f:'- 

>  '  m 

1 

\'l 

i<i    ■.1    m\ 

k. 

a  u 

i!. 


"  Upon  the  4th  or  5(h  day,  the  dressings  were  removed ;  the  ad> 
hesive  straps  had  not  adhered  with  sufficient  Torce ;  the  lips  of 
the  integuments  had  separated  to  the  distance  of  an  inch  ot 
more.  New  strips  were  applied,  and  the  lips  brought  together 
as  near  as  possible  without  using  force.  This  man  was  after- 
wards dressed  by  others,  and  confined  in  a  room  with  many,  both 
wounded  and  sick  with  typhus.  He,  in  a  few  days,  was  also 
seized  with  the  fever,  and  died  in  about  thirty-nix  days  after  the 

amputation.  -■  f^'J-       s-'-'^rf^^^^- ■- >■      '■■■".>■■!:     .  .:,      :vi     *:  '^ - 

"  Had  this  patient  been  removed  from  a  foul,  crowded  hospital, 
as  soon  as  the  limb  had  been  taken  off,  and  received  that  atten- 
tion his  case  required,  there  is  little  doubt  but  he  would  have  re- 
covered in  a  reasonable  time.  But,  without  charging  the  sur- 
geons and  nurses  with  negligence,  it  is  not  to  be  expected  that 
160  wounded  men  could  receive  every  necessary  attention  which 
their  sufferings  deow-aded." 

.,V-'vi   ■■...".a     -J-  J..  V    r^-,    ,■   :■.;„       REMARKS.    ,,..'■ 

This  case  was  attended  at  Sacketfs  Harbour,  where  the  au- 
thor was  not  at  the  time.  He  has  heretofore  observed,  that  no 
infectious  disease  was  generated  at  those  points  where  he  per- 
formed duty.  The  above  patient,  agreeably  to  the  statement, 
?ost  his  life  in  consequence  of  being  placed  in  a  foul  hospital. 
If  an  hospital  is  foul,  no  persor.  but  the  director  can  be  censured. 
When  patients  die  in  foul  hospitals,  the  surgeons  are  as  culpa- 
ble for  their  deaths,  as  if  they  had  been  improperly  treated  by 
medicine  or  wholly  neglected.  A  foul  hospital  is  no  excuse  for 
want  of  success  in  practice. 

The  following  case  reported  hy  hospital  surgemi's  mate  March. 

Upon  the  6th  July,  1813,  Simeon  Grant,  of  Castine,  Dis- 
trict of  Maine,  a  sailor  belonging  to  the  schooner  Scourge,  on 
Lake  Ontario,  comjianded  by  sailing-master  Osgood,  being  in 
a  saw-mill,  his  hand  was  caught  by  the  saw,  and  was  separated 
at  the  wrist  joint,  the  carpal  bones  were  torn  asunder  by  a  stroke 
of  the  saw ;  no  hemorrhage  succeeded.    An  immediate  amputa- 


SURGERY. 


G2fJ 


lion  ivas  performed  about  half  way  between  the  wrist  and  elbow, 
by  semicircular  and  angular  incisions ;  their  angles  meeting  on 
the  outside  of  the  ulna  and  radius.  The  dressings  were  remov- 
ed th«  fourth  day ;  it  was  not  fcKind  necessary  to  remove  the  ad« 
hesive  straps  until  the  day  follow  ing,  when  the  lips  of  the  wound 
were  nearly  in  contact,  and  the  integuments  united  by  the  first 
intention.  After  the  6th  day  the  ligatures  were  solicited,  but 
were  not  removed  until  the  12lh  and  15th.  In  four  weeks  th9 
cure  was  finished.  ^V'^rt7 

REMARK. 

'  ,  t  Union  of  the  integuments,  over  the  stump  of  an  amputation, 
succeeds  immediate  amputation  more  frequently  than  consecu- 
tive.   •  yj,,  (^(f/ft^,    >ffr.;»t^  r\«f;vf,r(  ^■'■i^^j  ".^''♦'»'^v*)^!*v»w-»7  /^jf^   ',^*ifti 

CASE  SECOND,    .tftlf^ff^^ti  ■■■iitnf'--f'^i.  .    tr,\i 

When  there  is  a  convulsive  spasm  in  the  wounded  limb.  "  If  a 
limb  be  amputated  as  soon  as  tetanus  appears,  all  communication 
between  the  origin  of  the  disease,  and  the  general  system  is 
cut  off.  This  division  removes  the  nervous  pain,  by  separating 
the  local  irritation  from  the  rest  of  the  body ;  if  this  is  performed 
before  the  general  system  partakes  of  the  diseased  mobility  of  the 
muscles,  caused  by  their  sympathising  with  this  wounded  part, 
tetanus  will  be  obviated,  iu^t  if  tetanus  has  become  general,  it 
is  doubtful  whether  amputation  will  succeed  to  remove  the  spasm. 
The  momentary  pain  produced  by  the  operation,  cannot  aug- 
ment the  enlisting  irritation.  The  pains  of  tetanus,  over-balanc- 
ing those  which  arise  from  the  operation,  make  it  more  support- 
able, and  diminish  the  intensity  of  pain,  especially  when  the 
nerves  of  the  limb  are  strongly  compressed."  .  i^r^ 

During  the  campaigns,  no  instance  c  tetanus,  either  from 
wou  ids  or  any  other  cause  came  within  my  observation. 

CASE  TUIRD. 

"^ViHaled  suppuration. — It  often  happens  in  gun-shot  wounds^ 
complicated  with  fracture,  that  ip  opposition  to  the  best  directed 
care,  suppuration  becomes  putrid,  and  the  bony  fragments  are 


'1 

1;    i 

1  ; 

\\ 

I 

11. 


I 


i; 


lii' 


I 

1  : 

\ 

^?i 

\ 

< 

1'! 

■>  -v, 


224 


«URGERY. 


If 

1'      » 


li 


enveloped  in  pus,  ant)  have  no  dispoeUion  to  unite.  Hectic  fever 
and  colliquative  diarrlioea  weaken  tlie  patient,  and  in  this  extre- 
mity amputation  has  saved  his  life,  and  by  removing  the  source 
of  matter  absorbe/d,  the  above  evils  are  obviated."  The  wound, 
from  being  complicated,  becomes  simple.  The  system  recovers 
froi.i  its  languid  state,  as  soon  as  causes  opposed  to  healthy  ac- 
tion are  removed."  I  have  witnessed  cases  of  the  above  descrip- 
tion, where  cures  progressed  astonishingly  quick  after  amputa- 
tion was  performed.  ■^'  -inii  i-.^j:  .  i  . 
Gun-shot  wounds  of  the  thigh,  complicated  with  a  fracture 
of  the  femur,  may,  in  most  instances,  be  cured  by  the  immediate 
application  of  Desault's  splints,  constructed  for  extension  and 
counter-extension  of  the  limb.  Doctor  Physick  of  Philadel- 
phia, has  improved  Desaui.t's  plan.  Some  within  my  knowl- 
edge have  had  their  limbs  saved  by  them ;  while  many  have 
not  only  lost  limbs,  but  Uves  for  want  of  their  seasonable  cm 
ployment.        -  ■    ■■"■■'■■         .      ..; 


•»n  H«  .'Mr'nfc 


•^i  !•).  Cm  orn:'  •.;!  i'r:;i 


*  CASE  KOURTU.  "       • 

Bad  state  cf  the  stump. — The  cure  of  stumps  is  arrested  by 
fevers,  and  exposures  to  cold.  Subsequent  to  the  battle  of  Little 
York,  the  wounded  were  exposed  in  tents,  on  the  Niagara,  in  the 
rtionth  of  May,  wanting  warmer  accommodations.  The  integu- 
ments preserved  to  cover  the  surface  of  the  stump,  did  not  unite 
for  want  of  adhesive  inflammation ;  large  vitiated  suppurations, 
a  retraction  of  the  muscles  round  the  bone,  which  left  it  project- 
ing beyond  the  surface  of  the  wound,  from  one  to  two  inches, 
supervened.  These  projecting  ends  of  the  bones  were  amputa- 
ted. The  cures  of  several  were  retartled  by  exposures  to  cold 
and  unhealthy  situations.  After  the  sick  were  removed  to  Lew- 
istown,  the  weather  became  more  pleasant ;  the  wounds  assumed 
a  better  appearance  and  finally  were  healed. 

We  coincide  with  Larrey  in  opinion,  that  "  under  any  cir- 
cumstance, amputation  should  be  the  last  resort.  But  when 
there  is  a  decided  necessity  for  performing  it,  there  should  be  no 
hesitation  nor  delay.  The  operation  should  be  performed  be- 
fore the  iiivasioo  of  the  primitive  syroptonis.    If  they  have  tak- 


1 1-  I 

nil 


SURGERY. 


225 


ea  place  when  the  sargeon  is  called  to  the  assistance  of  the 
wounded,  he  should  wait  until  the  (irst  inflammation  is  removed.** 
Larkey  establishes  it  as  a  principle,  where  a  ball  has  fractured 
the  femur  at  the  condyles,  to  perform  the  amputation  immedi- 
ately. Wounds  of  the  thigh  with  fractures,  are  always  danger* 
ous,  and  if  not  immediately  secured  in  a  state  of  extension  by 
Dbbault's  or  Physick's  method,  the  limb  cannot  be  saved. 
Where  the  radius  is  shattered,  and  ulna  fractured  near  the  eN 
bow,  Larrey  divides  the  ai>oneurosis,  removes  the  splinters, 
and  dresses  the  wound  with  a  view  to  preserve  the  limb.  All 
sphacelated  limbs  in  consequence  of  gun-  shot  wounds,  as  well  as 
extensive  lacerations,  require  immediate  amputation. 

Gun-shot  wounds  through  the  trunk,  are  not  always  necessari- 
ly moKal.  Men  frequently  survive  wounds  through  the  lungs, 
by  musket  balls  and  the  bayonet,  also  through  the  abdomen.  It 
cannot  be  always  ascertained  to  what  extent  a  viscus  is  injured ; 
whether  an  intestine  or  an  important  blood-vessel  is  lacerated. 
When  either  of  these  last  have  taken  place,  the  event  will  soon 
determine.  But  in  cases  where  the  membranous  coverings  of 
the  viscera  are  only  wounded,  and  the  extreme  danger  arises 
from  consecutive  inflammation,  the  intention  is  to  obviate  its 
excess  by  liberal  blood-letting.  A  ball  passeu  through  the  left 
lobe  of  the  lungs,  the  man  fell  on  his  face,  and  fainted  from  loss 
of  blood.  His  position  on  the  ground  favored  the  egress  of  blood 
from  the  wounded  chest.  After  two  hours,  he  was  found  with 
scarcely  the  symptoms  of  life,  was  taken  to  the  hospital  and 
eventually  recovered.  In  this  case,  there  is  no  doubt,  the  ex- 
cessive loss  of  blood  was  a  cause  of  recovery,  by  obviating  high 
inflammation.  Repeated  instances  of  similar  cases  may  be  re- 
lated, where  wounds  from  the  same  cause  had  a  favorable  termi- 
tion.  The  more  blood  exitended  the  better,  in  wounds  of  the 
viscera,  provided  life  is  not   exhausted,  when  hemorrhage  is 

stopped.         lit'  '  n^.rt  t     tj*!   ,<..-.)  ,     i'-.   ■      ,.      \     }i<if  ■■•■,>  t):j  ^xi  ;.-■   . 

A  soldier  at  Greenbnsh  was  wounded  by  a  bayonet,  which 
entered  the  left  of  the  spine,  i)assed  through  the  trunk  below  the 
diaphragm.  This  man  was  attacked  with  puking,  and  sufiered 
extreme  pain.    He  was  bled  immediately  j  the  operation  was 


ii 


1 

Ir      (     r 

i'J.!  !, 

^!|  1    ■ 

1     ' 

5 
'11 

:i 


t 


■■! 


; 


i: 


n 


u/ 


f  i'.\ 


.M(eia:iilm'<w;i\-ti  a  V  A 


B«fri«tot;Miiv.4.A^^^ 


T 


nt 


226 


bURGERY. 


y 


i'3,, 


1 

-  J 

^  i 

■  i 

1 

! 

ill 

■ 

repeated  as  paiu  indicated,  until  he  lost  two  quarts  in  tiiirty'SiK 
hours.  Anodynes  were  administered.  The  bowels  were  kept 
open  by  injections.  Within  three  days  the  puking  ceased,  when 
the  man  became  composed.  At  the  expiration  of  three  weeks, 
the  wound  healed  without  suppuration;  at  the  same  time  he  was 
seen  to  bring  a  bucket  of  water  in  each  hand,  sixty  rods.  It  is 
good  practice  to  bleed  in  all  cases  of  wounds  by  musket  balls, 
or  bayonet,  where  there  is  but  little  loss  of  blood  from  t)^    wound. 

An  officer  at  Little  York,  was  wounded  by  a  bayonet,  in  the 
axilla,  which  divided  the  artery  ;  he  bled  until  he  fainted,  when 
the  hemorrhage  ceased.  This  wound  was  cured  without  any  un* 
pleasant  accident,  the  consequence  of  excessive  loss  of  blood. 
Bleeding  from  a  wounded  axillary  artery,  may  be  stopped  b^  a 
compression  immediately  under  the  clavicle.  Sometimes  it  has 
been  found  necessary  to  dissect  down  through  the  integuments, 
over  the  artery  under  the  clavicle,  and  secure  it  at  that  point 
with  a  ligature. 

When  loss  of  blood  is  accompanied  with  deliquium  animi,  he- 
morrhagia  frequently  ceases  spontaneously,  and  life  is  preserv- 
ed, provided  stimulants  are  not  hastily  administered.  Tempora- 
ry faintness  may  be  obviated  by  them,  while  their  effects  are 
permanently  injurious.  In  these  cases  the  patients  should  be 
supported  by  soft  nutritious  vegetable  diet,  at  tirst  only  sufficient 
to  support  life,  afterwards  by  milk.  Animal  nutriment  should 
he  prohibited,  until  symptoms  indicate  t^it  the  wounds  of 
the  viscera  are  healed.  Gun-shot  wounds  through  the  lungs 
are  always  accompanied  with  more  or  less  cough  and  expecto- 
ration. These  are  increased  by  indulgence  in  the  use  of  stimu- 
lating drinks  and  diet.  To  allay  irritation  opium  is  necessary. 
The  external  wounds  always  heal  before  the  lungs  become  sound. 
Instances  have  occurred,  where  upon  the  closing  of  the  external 
wound,  the  lungs  have  exhibited  increased  symptoms  of  danger, 
Avhicli  have  been  obviated  by  removing  the  cicatrix  and  making 
an  opening  into  the  chest,  at  the  most  depending  wound.  Chin- 
chona,  which  is  too  frequently  and  indiscriminately  administered 
in  gun-shot  wounds,  is  of  no  use  in  wounds  of  the  lungs.  On  the 
northern  frontiers  we  had  full  evidence  of  the  truth  of  the  above 


SURGERY. 


227 


position.    In  cases  of  amputation,  the  bark  waa  but  seldom  nee- 
cssary. 

I  have  frequently  observed  evils  originate  from  the  liberal  aA* 
ministration  of  bark  and  wine  in  gun-shot  wounds,  especially  in 
cases  of  amputation.  I  amputated  a  leg  in  consequence  of  a  ca- 
ries of  the  tarsal  bones,  produced  by  a  wound  from  a  sharp  in- 
strument. The  patient  at  the  time  had  a  cough,  accompanied 
with  hectic  fever.  The  complaint  on  the  lungs  was  thought  to 
be  symptomatic,  and  it  was  believed  by  removing  the  diseased 
foot,  the  complaint  on  the  lungs  would  disappear.  But  we  were 
disappointed.  The  amputated  wound  assumed  a  favourable  as- 
pect. For  the  cough  and  hectic  symptoms  were  adminstered 
camp.  tine,  of  opium  and  antimonial  wine.  After  the  first  week 
the  patient  was  dressed  by  a  young  assistant,  who  immediately 
proposed  bark  and  wine ;  to  which  I  objecte«l.  At  the  expira- 
tion of  four  days,  the  wound  ujwn  examination  was  found  in  a 
bad  state;  the  hectic  symptoms  had  increased  with  loss  of  ap- 
petite, when  it  was  made  known  that  the  bark  and  wine  had 
been  administered  contrary  to  my  orders.  Then  the  case  was 
taken  into  my  hands.  An  emetic  was  prescribed.  After  which 
the  camp.  tine,  of  opium  and  antimonial  wine  were  again  resort- 
ed to.  In  two  days  the  cough  and  hectic  symptoms  subsided, 
appetite  returned,  the  appearance  of  the  wound  improved.  With 
a  continuance  of  the  last  medicine,  a  soft  nutritious  diet  and 
wine  in  small  quantities,  in  a  few  days  the  wound  was  cicatrized^ 
and  cough  apd  hectic  fever  were  removed.     •»  -.       »    s^     :  '  ■»% 

I  have  never  experienced  any  benefit  from  chinchona  and 
stimulants,  where  amputations  were  immediately  performed,  af- 
ter the  wound  was  received.  They  induced,  in  most  instances, 
inflammations,  abscesses  and  ill  conditioned  sinuses. 

In  consecutive  amputation,  even  when  the  patient  is  much 
emaciated,  bark  is  injurious  until  the  suppurative  stage  has  su- 
pervened. In  army  practice,  amputations,  where  the  superfi- 
cies of  the  wounds  is  covered  with  the  integuments,  seldom  heal 
by  l.:e  first  intention.  Primitive  inflammations,  the  consequence 
of  gun-shot  wounds,  with  fractures,  extend  generally  throughout 
the  limb,  which  in  twelve  or  fourteen  days  becomes  edematose. 


I.  >  'I  I  If 


I 


.1 


I 


^ 

u 

.i 


I; 


hi 


i; 


% 


V 


iit 


228 


SURGERY. 


I'    » 


'm 


H  not  obviated  by  emollients.  The  swelling  commences  vihctf. 
the  bone  is  fractured.  When  the  swelling  is  not  remedied  by 
permanent  extension  and  spiral  bandages,  extensive  sinuses  are 
formed  between  the  muscles ;  which  demand  amputation  of  the 
limb  to  preserve  life. 

Physick's  improvement  on  Desault's  method  of  extension 
Und  counter-extension  in  compound  fractures  by  gun-shots,  obvi- 
ates many  unpleasant  symptoms.  By  this  support,  the  fractured 
extremities  of  the  bones  are  preserved  in  their  natural  position ; 
irritation,  a  cause  of  inflammation,  extensive  suppuration  and 
deep-seated  sinuses  are  obviated.  Extension  and  counter-exten* 
sion  obviate  the  contraction  of  the  muscles,  which  shorten  the 
limb,  when  a  portion  of  the  bone  is  destroyed  and  removed. 
Where  there  is  no  loss  of  bone,  with  a  diagonal  fracture,  by 
means  of  Puysick's  splints,  the  limb  may  be  retained  at  its  full 
length;  while  pain  is  mitigated,  as  irritation  from  the  sharp  ends 
of  the  bones  is  prevented.  Too  many  attempts  were  made  to 
preserve  a  limb,  in  cases  of  compound  fractures,  without  the  use 
of  Physick's  splints.  It  was  urged  by  those  opposed  to  the 
method,  that  extension  could  not  be  endured  by  the  patients. 
To  my  knowledge,  their  conditions  were  infinitely  more  tolera- 
ble with  Physick's  splints  than  without  them.  At  the  com- 
mencement of  the  war,  only  a  few  surgeons  of  the  army  had 
witnessed  their  benefit.  Time  and  experience  were  necessary 
to  remove  prejudices.  Physick's  improvement  is  to  be  prefer- 
red to  Desault's  ;  the  extension  being  completely  under  the 
command  of  the  patient. 

A  surgeon  may  operate  well,  still  he  may  not  be  a  proficient 
in  his  art.  After  an  operation,  if  he  is  not  well  acquainted  wMh 
the  animal  economy,  he  cannot  cure  the  wound.  A  clean 
wound  upon  a  healthy  person  will  readily  heal  by  retaining  it? 
sides  in  contact ;  yet  a  different  practice  is  necessary,  or  more 
is  required,  where  the  constitution  is  impaired  ;  a  knowledge  oC 
which  is  only  acquired  by  inspection,  and  practice  of  dressing. 
Scientific  sui^ery  is  so  intimately  connected  with  a  medical  ed- 
ucation, that  to  be  a  proficient  in  the  healing  art,  he  should  be  a 
practical  surgeon.     By  practical  surgery — an  attendance  on 


1; ! 


SURGERY. 


220 


Iresring*  of  ivouncis  am)  ukersy  the  nature  of  the  living  body  ii 
mora  thoroughly  investigated,  and   habits  and  temperaments 
more  correctly  acquired.    Extpmal  inflaramations,  with  their 
most  suitable  treatments,  lead  to  a  knowledge  of  internal  aflbc- 
tiooa  of  a  similar  nature.     As  much  information  may  be  gained 
of  the  tnternal  states  o£  the  human  body  by  the  appearance  oS 
ulcers,  as  by  feeling  the  skin  and  pulse.     The  effects  of  extern 
nal  applicaitionB  are  allied  ta  internal.     Practical  surgery  famil«' 
iarizes  us  with  the  active  principles  of  life  in  all  temperaments. 
More  attention  is  often  paid  to  o()erative  surgery  than  to  scien^ 
tific      Some  ulcers  require  stimulant  applications,  ^hile  otherv 
demand  emoUients.     This  knowledge  is  only  acquired  by  prac- 
tice.    An  amputation  may  be  wcil  pciformed  by  one  little  skif- 
led  in  medicine ;  while  to  cure  a  wound  and  preserve  a  limb  re> 
4|iure  the  talents  of  the  most  experienced  practitioners.     To 
become  a  good  surgeon  a  man  must  be  a  good  physician.     These 
professions  are  inseparably  connected:     The  aspect  of  a  wound 
frequently  points  out  the  state  of  the  body,  and  indicates  thei 
most  suitable  remedies.     A  correct  method  of  practice  is  found- 
ed on  practical  facts  and  observations,  not  on  speculative  opin" 
ionSk     Tlie  first  are  stal)le,  the  last  fluctuating.     Experience  di- 
rects our  reason,  and  impresses  on  the  mind  flicts,  in  a  mannei! 
which  language  cannot.    Curative  indications  are  founded  upon 
an  acquaintance  with  the  laws  of  animal  life  both  in  health  andk 
disease.    In  cases  of  wounds,  to  form  an  (^linion  how  they  will 
terminate,  more  depends  on  the  habit  of  the  body  and  part  in- 
jured, than  on  the  application  of  a  dressing.    Upon  a  robust 
patient,  an  inflammation  will  supervene  proportionate  to  the  in- 
jury done,  or  other  concomitant  casualties ;  upon  one  weak  anA 
feeble,  a  wound  may  be  succeeded  by  spasms  and  convulsions. 
These  morbid  dispositions  are  to  be  obviated  by  different  and^ 
opposite  remedies,  known  only  to  the  practical,  scientific  sur- 
geon.  In  incised  wounds  where  the  skin,  cellular  membrane  and 
muscles  are  divided,  it  only  requires  to  bring  the  divided  parts 
in  contact,  and  secure  them  in  that  position  by  straps  of  stick- 
ing plaster,  with  a  pledget  of  any  mild  soft  ointment  to  exclude 
the  air ;  when,  if  the  patient  is  of  a  healthy  habit,  u  re-union  of 

30 


I 


'I 


1       ! 


i|    J 


7 


JW^ 


2^0 


eURGERY. 


r  -t 


ii 


•I? 


Ihe  divided  parts  will  follow,  and  in  a  Tew  days  he  will  be  cured 
by  the  firat  intention.  Here  inflammation  only  sufficient  to  eF- 
feet  adhesion  takes  place  between  the  sides  of  the  wound.  But 
a  bad  habit  of  body,  or  irregularities  of  life  will  prevent  this  ha|i> 
py  and  speedy  termination  of  the  wound,  and  will  require  such 
medical  treatment  as  ap[)earances  may  indicate.  Where  there 
is  much  inflammation,  bleeding  and  emollient  applications  are 
demanded ;  perhaps  cathartics,  as  neutral  salts,  or  castor  oil,  as 
well  as  antimonials.  Where  there  is  debility,  tonics  and  stimu- 
lants are  necessary.  An  incorrect  practice  of  securing  the  sides 
of  divided  muscles  by  stitches  or  sutures  should  be  avoided^ 
when  a  few  strips  of  adhesive  plaster  of  linen  will  better  fulfil 
the  intention,  without  causing  irritation  and  inducing  inflam- 
mation and  pain.  A  suitable  application  of  plasters  and  ban- 
dages will  generally  secure  divided  muscles  in  apposition ;  and 
even  where  wounds  are  contused  and  lacerated  by  blunt  instru- 
ments, a  retention  of  their  sides  in  as  close  union  as  possible  by 
straps  of  adhesive  plasters,  obviates  great  suppuration,  and  ex- 
pedites their  filling  up  with  new  granulations,  and  accelerates 
cicatrization.  '  > 

It  has  been  already  noticed  in  the  preceding  sketches,  that 
many  soldiers,  after  their  passage  down  lake  Ontario  and  river 
St.  Lawrence,  were  afllicted  with  edematose  swelled  legs.  In 
many  instances,  the  swellings  were  accompanied  with  both  fun- 
gous and  callous  ulcers ;  the  consequence  of  long  exposures  to 
cold,  wet  and  inclement  weather ;  also,  a  want  of  exercise  of 
the  lower  extremities  while  on  their  passage  down  in  open  boats, 
confined  on  their  seats ;  supported  with  coarse,  and  in  some  in- 
stances damaged  rations,  irregularly  administered,  or  after  long 

-iods  of  abstinence.  Under  these  circumstances  a  small  scratch 
soon  enlarged,  and  by  frequent  exposures  in  water,  deteriorated 
to  a  most  formidable  ulcer,  in  extent  from  six  to  twelve  inches 
up  and  down  the  legs.  it'    .     ' 

The  following  treatment  was  adopted  ; — after  the  ulcers  v/ere 
washed  clean  with  water,  in  which  a  little  soap  was  dissolved, 
adhesive  straps  were  ajoplied  across  them  so  as  to  support  the 
pendent  muscles  on  tJie  side  opposite,  as  well  as  the  integuments 


\'A 


SURGERY. 


231 


at  tite  iimi^in  or  the  ulcers.  Over  the  straps  was  applied  dry 
lint,  instead  or  pledgets  armed  with  ointment.  To  remove  Tun^ 
gosities,  the  nitrate  of  silver  was  applied ;  and  when  the  ulcers 
shewed  little,  or  no  disposition  to  granulate,  the  surface  was  oc>- 
easionally  stimulated  with  mere,  precip.  rub.  Over  the  whole 
dressing  was  applied  a  s|)iral  bandage,  commencing  at  the  toes 
and  extending  above  the  knee ;  and  where  the  swelling  had  ht- 
tacked  the  thigh,  the  spiral  bandage  ;vas  continued  up  to  the 
trunk  of  the  body.  Cathartics  were  occasionally  administered^ 
When  the  ulcers  continued  ill-conditioned  after  the  above  means 
were  eniydoyed,  the  chinchona  was  directed  to  give  tone,  but 
seldom  with  any  benefit  excepting  in  cases  of  sphacelus.  A 
laudable  digestion  and  healthy  granulation  was  better  promoted 
by  calomel  in  small  doses.  When  the  patients  were  restrained 
from  ardent  spirits,  and  confined  to  a  milk  and  vegetable  diet 
with  light  soups,  their  recovery  was  astonishingly  rapid.  Dur* 
ing  the  winter  1813 — 14,  there  were  in  the  hospital  at  Burling* 
ton  more  than  one  hundred  of  the  above  described  cases. 

The  following  case  o(  anthrax  admitted  into  the  hospital  at 
Malone,  is  worthy  of  being  recorded  in  detail.  A  small  swel- 
ling appeared  immediately  over  the  vertebrse  of  the  neck,  equi* 
distant  from  the  occi|>ut  and  the  first  dorsal  vertebre,  not  unlike^ 
at  first,  a  small  phlegmon,  but  as  it  progressed  it  was  character- 
ized with  marks  essentially  different.  It  commenced  with  shoot- 
ing pains  through  the  tumor,  whicb  at  first  was  red,  and  after  a 
few  days  livid ;  when  were  noticed  upon  its  surface  small  vesi- 
cles filled  with  a  thin  yellowish  matter.  The  tumefaction  con- 
tinued to  extend  from  its  centre  to  the  circumference  in  every 
direction.  When  the  vesicles  burst,  the  subjacent  <!utis  was 
found  perforated,  exhibiting  small  ulcerations  througltout  the  tu- 
mor, scarcely  large  enough  to  admit  the  blunt  end  of  a  probe ; 
through  which  issued,  when  the  tumor  was  compressed,  a  smalt 
quantity  of  purulent  matter.  At  this  perioil  the  tumor  felt  spon- 
gy in  its  texture,  deep  and  firmly  attached  to  the  subjacent 
parts,  and  assumed  at  its  centre  a  black  appearance  ;  then  dry, 
hard  and  depressed,  while  its  circumference  continually  enlarged; 


I,  i 


.  i 


I 


I 


li'i  1 
•1  ?   i 


'*: 


^yyn' 


232 


SURGERY. 


The  gangrene  progrfttivelj  and  rapidly  exterMl(>(I  rrotn  ita  epQ. 
Ire  to  4b«  eircumference. 

This  patient  when  admitted  into  tiie  hospital  at  MalAiie  «nt 
extremely  enaoiated  and  detiilKnted.  The  «ynBputbetic  fever, 
which  ufually  accornpaates  pbief^aonotn  iufliimmation  did  not 
exist ;  the  tongue  vrna  dry  and  of  a  dirty  yeliuw.  A  soft  iiutri« 
liout  diet  with  wine  was  preacrilied  during  the  first  etate  of  the 
diaeaae.  A*  emollient  |M)uUice  of  the  hark  of  slippery  elm  was 
Upplied  over  the  swelling.  On  tlie  fourth  day  Ofifienred  the 
0OiaU  vesicles.;  on  tlie  ftfth  tlie  chinchona  with  an  increased 
quantity  of  wine  was  directed ;  on  the  eightli  day  the  twnor  was 
iphacelale<l  tbrougheut  its  whole  extent ;  when  the  mortified  part« 
ivere  eeporated  from  the  sound  l*y  Doctor  VikNHoi.,  hospital 
mate.  Tiic  diameter  of  the  open  ulcer  then  wa«  not  less  than 
five  inches.  The  wound  was  washed  with  diluted  muriatic  aeid» 
and  filled  with  eluttcltona  in  pc^wder.  The  bark  in  auhetance 
"was  administered  in  quantity  as  much  as  tlte  stomach  could  bear 
with  wine.  The  eleventh  day  the  moKified  Jooee  parts  which 
were  attached  to  the  wound  sloughed  off  from  the  sound,  and  ex- 
posed to  view  some  of  tl>e  procesees  of  tlie  verlebre  of  the  neck. 
The  dreesings  of  bark  were  continued  a  few  days,  until  new 
granulations  were  seen  rising  from  the  surface  of  the  wound ; 
-when  the  usual  dressings  of  lint  and  a  pledget  spread  over  with 
cerate  were  applied.  As  the  wound  filled  up  from  its  base,  it 
contracted  in  its  dimensions,  and  in  a  few  weeks  wae  red jced 
from  a  deep,  ei;ten8ive,  fetid,  gangrenous,  to  a  healthy,  saperfi* 
cial  ulcer,  the  size  of  half  a  doUar ;  and  was,  a  short  period  after, 
eompletbely  eieatrieed. 

A  sokUer,  Brown,  was  admitted  into  tli«  hospital  at 

Lewislown  in  July,  18)3,  who  had  previously  been  reduced  by 
fever  and  diarrhoea.  When  admitted,  his  extremities  and  face 
irere  extremely  emaciated,  and  his  abdomen  UMjch  swollen  and 
tense.  It  was,  on  first  inspection,  apprehended  that  the  swelling 
was  dropsical.  From  his  general  emaciated  appearance  and  ex- 
treme  debility,  it  was  believed  he  could  survive  but  a  few  days ; 
and  not  being  a  subject  for  active  medicine,  the  only  indication, 
jvhich  bis  miserable  condition  pointed  out,  was  such  support  as 


SURGERY. 


233 


foft  nutriment  and  wine,  with  opium  to  procure  case,  miglit  ar> 
ford.  After  tliree  weelcs  tlie  attending  sui^'eon,  to  my  nstonisli- 
ment,  reported  liim  still  living ;  when  he  proposed  to  perform 
the  operation  of  paracentesia  on  the  abdomen.  At  this  period 
being  confined  to  my  tent,  and  not  having  seen  this  patient  af- 
ter the  first  examination  of  the  case,  the  operation  was  perform- 
ed in  the  presence  of  no  surgeon.  The  following  day  upon  en- 
quiry, it  was  learnt  that  the  opening  was  made  in  the  region  of 
the  liver ;  and  that  a  discharge  of  pus  followed  the  o|)eration. 
The  patient  still  lived ;  at  the  expiration  of  three  weelts  tho 
case  waa  examined  by  myself,  when  it  was  very  evident  that  the 
trochar  not  only  penetrated  the  parietes  of  the  abdomen,  but  in- 
to the  cist  of  an  abscess  ia  the  liver ;  the  discbarges  from  the 
opening  had  gradually  enlarged  the  external  puncture  to  the 
size  of  an  inch  and  quarter  in  diameter.  Notwithstanding  all  the 
unfavourable  circumstances  of  the  case,  the  general  health  of  the 
body  was  improved ;  the  appetite  was  better,  the  stomach  waa 
capable  of  receiving  more  nourishment  than  at  first ;  milk  being 
the  principal  diet.  Now  bark  and  wine  were  administered  with 
good  effect.  His  health  continued  to  improve,  so  tliat  he  waa 
able  to  leave  that  frontier.  The  winter  following  he  was  seen 
either  at  Greenbush  or  Burlington  hospital  in  a  good  state  of 
health ;  the  0[>ening  into  the  liver  having  entirely  healed. 


l!» 


•I  rwf 


•'.   t 


OF  HOSPITALS. 


The  eocial  affections  have  enlarged  their  sphere  or  operation, 
B8  the  arts  and  sciences  have  progressed.  No  longer  confined 
to  a  small  circle,  they  embrace  not  only  nations,  but  the  human 
race  as  one  family.  Dissentions  and  their  bitter  consequences 
arc  nevertheless  excited  between  nations.  As  in  the  small  fam- 
ily contested  interests  engender  strife ;  so  in  the  large,  conten- 
tions more  extensive  and  permanent  are  productive  of  destruc- 
tive warfare,  merciless  devastations  and  a  miserable  waste  of  hu- 
man life. 

In  proportion  to  the  value,  a  people  estimate  their  property 
and  privileges,  the  defence  of  them  will  be  sanguinary.  The 
most  valuable  of  all  possessions  are  liberty  and  independence. 
In  support  of  these,  the  lives  of  thousands  are  sacrificed.  To 
maintain  these,  wars  the  most  vindictive  have  existed.  Still 
under  the  highest  excitements  of  inflicted  injuries  and  violated 
rights,  the  soothing  influences  of  civilization  ameliorate  the  evils 
attendant  on  these  national  calamities.  They  render  the  con- 
lion  of  the  conquered  less  severe,  as  they  soften  the  ferocious 
temper  and  disposition  of  man. 

Uncivilized  man  inflicts  upon  his  captive  tlye  most  dreadful 
tortures,  or  death.  If,  in  any  instance,  life  is  preserved,  it  is  to 
aabject  him  to  ignominious  slavery.  The  sick  and  wounded 
prisoner  never  excites  a  feeling  of  compassion  in  the  breast  of 
his  savage  conquerors,  but  is  generally  doomed  to  sufiier. 

The  wars  of  civilized  nations  to  the  conquered  are  less  dread- 
ful than  of  savage.  To  become  a  prisoner  to  the  first  is  not  the 
Wor  '    \  evils.     The  captive  soldier  is  uo  longer  viewed  9»  an 


HOSPITALS. 


335 


tjhpmy.  He  recclveB  from  the  victor  every  uttention  which  hu- 
manity (lictAtei,  nnd  circumBtances  allow.  The  healing  halm  \» 
a|>|tliutl  to  his  wouiuIb,  and  his  diBpirited  heart  is  revived  by  the 
cordial  draught.  Instancea,  however,  there  have  l)een,  where 
the  conqueror,  diveating  himseir  of  the  fine  feelings  which  char- 
acterize the  human  heart  in  civil  society,  has  satiated  his  thirst 
for  revenge,  by  inflicting  misery  and  distress  when  the  fortune 
of  war  has  placed  his  enemy  in  his  iKiRsession.  Crimsoneit  with 
tlie  blood  of  a  defenceless  prifoner,  the  victor,  although  «>dut  ated 
in  civil  life,  is  but  a  savage.  •  '■ 

In  ancient  wars  pestilence  and  disease  were  more  destructive 
to  armies  than  the  sword  of  the  enemy.  Ignorant  of  their  caus- 
es, the  Gods  were  believed  by  the  multitude  the  immediate,  or 
secret  agents  of  pestilential  calamities.  To  avert  their  mortali- 
ty, prayers  and  incantations  were  resorted  to,  instead  of  more 
appropriate  measures — cleanliness  and  ablutions.  Prophylactic 
means  were  neglected ;  putrid  gasses,  mofitic  airs,  and  marsh 
miasmata  hud  do  place  in  ancient  nomenclatures  ;  while  urmies 
were  wasted  by  diseases,  generated  by  them  and  their  own  tilth. 
In  proportion  as  superstition  has  yielded  its  influence  upon  the 
mind  to  general  science,  so  have  philanthropy  and  benevolence 
Iirevailed,  and  human  calamities  been  overcome,  or  their  causpi 
obviated. 

Medical  philosophy  investigates  the  disease,  and  points  out 
its  preventive  and  curative  means ;  while  ingenuity  is  called 
into  action  in  war,  to  furnish  the  instruments  of  human  de- 
struction. 

In  modern  times,  systems  of  military  operations,  plans  of  at- 
tacks, and  methods  of  slaughter,  are  not  the  only  preparatory 
measures  for  warfare.  Accommodations  for  the  sick  and  wound- 
ed of  an  army,  are  among  the  first  considerations  of  military  ex- 
peditions. 

Hospitals  are  established,  to  which  a  medical  staff  is  assigned, 
distinct  from  that  immediately  attached  to  the  line  of  army. 
The  medical  department  is  not  its  least  important  appendage, 
and  when  well  appointed,  may,  by  its  efforts,  ensure  strength, 
and  give  energy  to  its  movements ;   not  merely  by  attention  t© 


i| 


III 
I' I? 

:)l 


': 


I         - 


1! 


,ii 


■'4' 


hi 


l^ 


^    1 


I, 'ill 


t)0 


HOSPITALS. 


the  sick  and  ii'ooBded,  but  by  recommeiiding  prccautionarf 
meMure»,  to  seciwe  to  the  soldierj*  health,  and  obviate  diteaaesy 
to  which,  in  the  teoted  field,  men  are  aubjectedi. 

The  good  of  aervice  requtreft  tliat  the  medical  staff  of  an  army 
be  not  only  well  a|;H>o^"t®(l>  ^  respected  by  the  effieen  of  the 
line.  Without  due  respect*  advice,  given  by  surgeons  however 
correct,  will  not  be  regarded,  especially  by  young  inexperienced 
officers.  Invested  as  they  are  witii  authority*  they  often  affect 
to  despise  counsel  offered  by  surgeons;  who,  under  the  present 
establishment,,  have  no  rank  nor  command  in  the  army. 

The  « ledical  department  will  uever  command  that  degree  of 
confidbtM^e  and  respectability  from  officers  of  the  line,  necessary 
to  promote  its  greatest  usefulness,  until  it  ia  more  immediately 
protected  by  government.  It  was  frequently  the  case,  during 
the  war,  that  commissnoned  officers,  of  inferior  grades,  intruded 
themselves  into  the  hospitals,  without  consulting  the  attending 
aui^eons,  and  without  their  knowledge  ordered  out  of  the  wards 
the  convalescent  men ;  and  when  detected  in  such  anmititary 
conduct,  justified  themselves  by  claims  of  superior  rank.  Offi- 
cers commanding  regiments,  who  had  been  long  in  service,  were 
guilty  of  similar  misdemeanours.  Interferences  of  this  descrip^ 
tion,  at  the  commencement  of  the  war,  were  extremely  vexatious 
to  the  surgeons.  In  one  instance,  a  Colonel  ordered  lv»  Quar- 
te^master  to  take  possession  of  barracks  already  occupied  by 
the  sick,  who,  weak  and  infirm  as  they  were,  left  their  beds,  and 
preferred  to  expose  themselves  without  doors,  on  the  ground,  to 
being  crowded  and  overrun  by  healthy  rude  men.  At  another 
time,  a  sergeant  regularly  appointed  to  perform  the  duty  of  Stew' 
«rd  in  a  hospital,  was,  at  the  moment  ef  making  issue  of  stores 
to  the  sick,  taken  from  his  duty  by  a  file  of  men  under  anns,  by 
an  order  from  tlie  Commandant  of  bis  regiment,  for  tite  allied 
crime  of  neglecting  to  join  his  regiment,  upon  his  order. 

Irregularities  like  these  were  remedied  only  by  a  special 
order  of  the  Commanding  General.  Whereas,  had  the  surgeons 
been  invested  with  explicit  and  distinct  powers,  in  their  own  de- 
partment, and  these  inserted  among  the  rules  and  regulations  of 
the  army,  troublefome^  collisions  w^d  have  been  Avoided. 


f  ^^  f 

ill-         !'■*       t' 


HOSPITALS. 


231 


That  the  medical  staff  of  the  army  was  not  respected  in  pro- 
portion to  its  importance,  was  evinced  by  facts  whicii  are  Bof 
justifled  upon  any  principle,  civil  or  military.  They  were  en< 
gaged  in  more  unpleasant  rencounters  with  officers  of  the  line, 
than  those  otficeiti  were  with  each  other.  As  many  of  the  sur- 
geons of  the  army  s!«cri(iced  their  lives  in  support  of  what  was 
falsely  called  their  honour,  as  of  commiseieoed  officers  of  the 
line.  These  fatal  evils  occurred  at  periods  when  medical  assist- 
ance was  most  in  demand.  >,  '     '  ♦  >*<•■■>'   '  .  ii*»<    V 

The  first  transition  to  which  a  recruit  is  exposed,  when  hf 
quits  domestic  employment  for  a  camp,  is  a  change  of  diet. 
Vegetables,  excepting  bread,  are  not  a  part  of  hi?  ration.  The 
meat  allowance  is  more  than  he  requires  were  vegeti*bles  made 
a  part  of  his  ration ;  and  where  it  might  be  ccavenient  to  com* 
mute  a  part  of  the  meat  for  beans  and  peas,  U  would  conduce  to 
Ms  health.  But,  in  active  services,  the  proposed  conmiutation 
would  be  impossible,  as  the  transportation  jf  animal  food,  being 
less  bulky,  is  le.s  expensive.  The  beef  ration  of  an  army^reo 
quently  travels  with  the  troops. 

A  change  of  lodgings  from  dry  houses  to  tents,  exposed  to  at- 
nospheric  damps,  and  evaporations  from  the  ground,  predispose 
men  to  disease,  by  obstructing  perspiration.  This,  in  some  de- 
gree, may  be  obviated  by  woolen  shirts,  at  all  seasons,  on  the 
north-western  frontiers.  ,•  -        •.  ,;,    ^  .  ^ 

The  sick  and  wounded  of  an  army,  wlieu  suffered  to  continue 
with  their  corps,  impede  military  operations.  It  has,  on  this  ac- 
count, been  found  expedient,  in  modern  wars,  to  select  some 
convenient  post  for  the  establishment  of  hos[Htals.  Positions 
not  too  remote  from  the  scenes  of  action,  nor  where  they  may 
be  exposed  to  depredations  of  an  enemy,  should  be  chosen.  A 
cultivated  country,  where  m'^'\  could  be  procured,  as  well  as 
vegetables,  is  preferable  to  towns,  or  thick  settled  villages.  The 
situation  of  hospitals  should  be  at  such  p  ints,  which  least  inter- 
fere with  extensive  military  movements  of  an  enemy,  and  his 
opposing  army.  Although,  agreeably  to  modern  warfare,  hospi- 
tals are  respected  by  an  enemy ;  yet,  established  within  the  com- 
pass of  active  movements  of  armies,  they  are  exposed  to  be  de*- 

31 


I 


m 

la 


i'l 


«// 


■>pr* 


^ 


HOSPITALS, 


-prived  of  such  necessary  supplies,  as  are  furnished  by  the  viN 
'Cumjacent  country. 

Elevated  lands,  which  command  a  free  circulation  of  air,  and 
«n  abundance  of  good  water,  are  preferable  to  plains,  for  the  site 
of  hospitals.  They  should  be  erected  at  a  distance  from  exten- 
tive  woods,  inhere  it  is  possible ;  in  an  open  country,  remote 
from  marshes,  or  swampy  lands ;  and  beyond  the  influences  of 
winds,  whose  currents  of  air  are  infected  with  miasmata  generat- 
ed on  sunken  lands ;  and  are  known  to  convey  with  them  the 
seeds  of  disease. 

A  military  hospital  wliich  is  considered  temporary,  built  oC 
rough  materials,  should  never  be  but  one  story  in  height. 

The  attendants  of  a  second  story  have  additional  duty  to  pe^ 
form;  the  sick  in  the  wards  beneath  are  incommoded  by  the  ne- 
cessary noise  of  walking  on  the  floors  over  their  heads.  In  the 
upper  wards  the  observance  of  cleanliness  is  with  difficulty  en- 
forced. Attendants,  rather  than  give  themselves  the  labour  of 
descending  a  flight  of  stairs  to  execute  their  duty,  take  liberties 
of  throwing  filth  from  windows  above,  to  the  annoyance  of  pa- 
tients below,  without  possibility  of  detection. 

The  wards  of  a  military  hospital  should  have  an  east  and  west 
aspect,  with  windows  on  each  side.  On  the  west,  a  closed  pas- 
sage should  extend  the  length  of  the  hospitail  12  feet  wide,  into 
which  the  doors  of  the  several  wards  open.  The  passage  should 
be  furnished  with  windows,  which  correspond  with  those  of  the 
wards.  Thb  passage  will  be  commodious  for  the  patients  able 
to  walk,  where  they  will  be  secure  from  cold  and  wet.  In  front 
of  this  should  be  an  open  piazza  projecting  ten  feet,  where  the 
patients  may  walk  unexposed  to  the  rays  of  the  sun  in  hot  weath- 
er. By  means  of  two  walls  and  the  roof  of  a  piazza,  heat  will  be 
excluded  the  rooms,  which  is  at  its  highest  in  hot  seasons,  after 
the  sun  has  passed  the  meridian.  These  walls  \i\\\  also  secure 
the  wards  from  cold,  during  the  severe  frosts  of  winter. 

Wards  of  an  extensive  hospital  «hould  be  thirty  feet  by  twen- 
ty four  in  dimenision,  and  not  less  than  eleven  feet  in  height; 
which  may  accommodate  twenty  patients,  if  not  sick  with  con- 
tagious diseases.    This  number  in  a  ward  reqjuires  only  two 


J»V 


HOSPITALS. 


saa 


nnnea,  when  their  diet  is  prepared  in  kitchens.  The  wards  of 
Burlington  hospital,  (which  had  the  reputation  of  being  under 
the  best  regulations  of  any  in  the  northern  district)  are  twenty 
four  feet  by  twenty,  and  nine  feet  high.  These  rooms  were 
found  by  experience  to  be  too  low.  The  windows  of  the  wards 
should  be  constructed  so  that  the  upper  sash  may  fall,  and  the 
under  rise  at  pleasure ;  that  when  ventilating  them,  the  air  may 
hahre  free  access  to  the  rooms,  without  passing  in  currents  imme- 
diately over  the  beds  of  the  sick. 

Convenient  rooms  should  be  appropriated  for  offices.  One 
to  contain  hospital  stores  under  the  charge  of  the  steward  of  the 
Iiospital  ;  one  for  the  use  of  the  ward  master,  under  whose  care 
is  placed  the  furniture  and  bedding ;  one  to  be  improved  as  a 
dispensary  ;  one  room  for  a  kitchen,  and  one  for  washing. 

The  hospital  department  should  be  furnished  with  spare  cloth> 
ing  as  well  as  bedding,  for  men  who  are  frequently  admitted  des- 
titute. During  the  war  it  was  frequent  that  the  wounded  lost 
their  clothing  in  battle.  Many,  after  the  action  at  Little  York, 
were  received  without  an  article  except  what  they  had  on  their 
backs,  who,  in  consequence,  were  not  only  dirty,  but  covered 
"with  tribes  of  lice.  As  soon  as  their  circumstances  were  report- 
ed, the  commander  in  chief  ordered  cloth  for  shirts,  but  they 
could  not  be  furnished  before  the  men  suffered  for  want  of  a 
change  of  garments. 

Each  patient  should  be  provided  with  a  separate  bed  in  a 
moveable  bunk.  When  bunks  are  attached  to  the  walls  of  a 
room,  as  has  been  sometimes  the  mode,  they  are  not  easily 
cleansed.  The  proper  dimensions  of  a  bunk  are  6  feet  8  inches 
in  length,  and  2  feet  8  inches  in  breadths. 

Various  methods  have  been  proposed  to  ventilate  the  wards  of 
A.  hospital.  A  hospital  having  east  and  west  aspects,  with  sin- 
gle rooms,  is  easily  ventilated ;  especially  where  the  windows 
are  made  with  double  sashes,  which  rise  and  fall. 

Chimnies  are  of  themselves  good  ventilators ;  no  dwelling 
house  should  be  destitute  of  them,  even  in  climates  where  fires 
are  unnecessary  to  warm  them.  A  wind-sail  suspended  over  the 
tpp  of  a  chinmey  by  two  posts  and  a  cross  piece,  and  its  funael 


' 


::  ri 


Uii 


It . 


n 


'I 


i*      'U. 


) 


240 


HOSPITALS. 


let  down  fiotn  the  top  as  low  as  the  fire  ptace,  will  throw  a  eol- 
umn  of  fresh  air  into  a  room,  which  will  expel  the  impure  air 
through  the  open  doors  and  windows.  These  can  be  employeit 
only  during  the  warm  seasons. 

Doctor  TiiiToiT,  Sui^on  General  of  the  army,  with  a  raind 
possessing  correct  principles  of  philosophy,  desirous  of  introduc- 
ing a  system  of  economy  creditable  (o  himself,  suggested  hospi- 
tals ui)on  a  novel  plan.     They  are  built  one  story  in  height  with 
round  logs,  having  a  fire  place  or  hearth  in  the  centre,  without 
a  chimney,  the  smoke  ventilated  through  an  inverted  woo<len 
funnel  affiled  to  an  opening  in  the  roof;  the  floors  of  the  rooms 
earth,  in  the  true  aboriginal  stile.     He  thinks  them  an  improve- 
ment as  they  respect  health.     Hospitals  of  this  description,  he 
believes,  obviate  diseases  which  have  their  source  from  impure 
air  of  crowded  rooms,  which  is  generated  from  animal  filth. 
The  Doctor  is  believed  to  be  correct  in  his  observations,  so  far 
as  wooden  floors  retain  infectious  principles,  while  earth  floors 
absorb  or  neutralize  tliem.     Examples  are  not  wanting  to  demon- 
strate, that  infectious  principles  attached  to  wood  retain  their  ac- 
tivity during  a  long  time.     An  imfwrovement,  which  is  truly  phi- 
losophical in  theory,  cannot  be  carried  into  practice  under  all 
circumstances.    The  plan  proposed  may,  in  southern  districts,  or 
milder  climates,  fulfil  the  benevolent  intention  of  its  learned  pro- 
jector.    These  hospitals  are  for  winter  months.     During  the  hot 
seasons,  tents  are  the  best  military  Iios[)ilals.     When  snow  cov- 
ers the  earth  to  a  considerable  depth,  it  dissolves  next  the  sur- 
face.    The  water  irrigates  under  the  bottoms  of  the   timber 
•which  composes  the  outer  wall  of  the  liospital ;  by  which  the 
earth  floors  are  rendered  uncomfortable  from  moisture,  and  tire 
beds  dii!/.     In  a  hospital  on  the  above  plan,  the  smoke,  in  its 
ascension,  may  convey  with  itself  infectious  principles ;  but  it 
aggravates  coughs  and  complaints  of  the  breast,  which  accwupa- 
ny  the  winter  diseases  on  the  northern  frontiers. 

These  hospitals  are  more  expensive  than  those  built  with 
framed  timber  and  i^lank,  excepting  when  the  timber  stands  in 
the  vicinity  of  the  spot  where  erected.  Upon  a  fair  calculation 
made  by  the  assistant  %  M.  General  at  Plattsburgh,  wliere  it 


HOSPITALS. 


e4l 


tras  neeeisaiy  to  draw  the  timber  one  mile,  the  expense  of  erect* 
ing  log  hospitals  upon  Doctor  Tilton'*  plan,  was  greater  than 
with  planked,  or  boarded  sides.  The  consequence  was,  the  Q. 
M.  General  absolutely  refused  to  give  his  assistance  to  erect 
them  u|)on  the  plan  proposed  by  the  Surgeon  General.  The 
ex|>eriment  to  demoHstrate  their  usefulness  was  but  partial,  at 
French  Mills,  where  the  army  remained  only  a  short  time.  No 
other  attempts  were  made  within  my  knowledge  to  prove  them, 
excepting  at  Brownville,  under  the  direction  of  Hospital  Sur- 
geon Blood,  who,  it  whs  said,  reported  favourably  of  them. 

The  nature  of  infection  and  the  means  of  obviating  it  were  so 
little  known  by  Sir  John  Pringlij:,  that  he  viewed  large  milita> 
ry  hospitals  us  the  graves  of  an  army.  The  same  opiniou  con- 
tinued in  Europe  and  America,  until  the  philanthropic  and  hu- 
mane Howard  explored  the  hospitals  in  many  of  the  kingdoms 
on  the  eastern  continent,  "  penetrated  the  dark  cells  of  despair, 
the  wretched  prisons  of  man,  where  the  seeds  of  disease  long 
matured,  diffused  their  pestilential  effects  ;  and  with  a  success 
unrivalled,  divested  them  of  their  deadly  powers.'^ 

The  soldiers  of  the  army,  at  the  commencement  of  the  war» 
possessing  all  the  prevailing  prejudices,  reluctantly  consented  to 
be  removed  into  the  military  hos{)itals ;  from  which,  after  recov- 
ery, they  as  reluctantly  departed,  having  once  experienced  then* 
as  comfortable  asylums. 

This  was  noticed  at  Lewistown,  on  the  Niagara,  where  it  was 
known  deceptive  arts  were  often  '  esorted  to  by  the  soldiers,  to 
induce  the  sui^eons  to  permit  liiem  to  remain  in  the  hospital, 
after  restoration  from  sickness,  and  able  to  perform  their  duty  in 
the  field.  Similar  decefrtions  were  more  frequently  practised  by 
the  men  at  Burlington  hospital ;  which,  in  point  of  cleanliness, 
had  claims  to  be  ranked  among  the  best  established  hospitals  in 
the  United  States. 

The  following  regulations  were  adopted  in  the  General  Hos- 
pital at  Burlington ;  where  in  no  instance  from  its  first  estab- 
lishment, even  when  the  monthly  reports  counted  from  six  to 
nine  hundred  men,  was  an  infectious  disease  generated,  or  propa- 
gated. 


i.^ii 


i  t 


11 :: 


1    ■•• 


ill 


l! 


\     A 


I      ii 


lii 


■ 


! 


:^\ 


<  pr^ 


242 


HOSPITALS. 


v\v- 


The  trashing  of  the  floors  and  walls  with  soap  and  water^  ty 
lime  water,  was  of  the  first  importance.  This  was  frequently 
repeated,  especially  during  hot  weather.  In  <:old  weather,  when 
the  wards  were  occupied  by  the  sick,  washing  them  was  not  on* 
1y  inconvenient,  but  hazarded  the  healtifi  of  the  patients.  A 
coat  of  sand  half  an  inch  thick  or  more,  renewed  on  the  floors 
every  day,  was  never  attended  with  ill  consequences,  but  was 
refreshing  to  the  sick,  while  it  superseded  the  necessity  of  wash^ 
ing.  White-washing  the  walls  V  "h  lime  and  water  never  in- 
commoded the  sick ;  it  sweetened  the  rooms  and  corrected  voit 
fectious  principles.  By  daily  sanding  the  floors  they  were  pre- 
served not  only  clean  but  perfectly  white.  The  opportunity  of 
washing  them  was  improved,  when  the  number  of  sick  was  re- 
duced so  as  to  aiimit  their  removal  from  one  ward  to  others. 
The  wards  were  thus  alternately  washed  and  thoroughly  repair- 
ed. Bunks,  as  soon  as  they  were  unoccupied,  were  removed 
from  the  wanls,  and  after  cleansing,  returned.  The  straw  of  the 
sacks  was  burnt  as  soon  as  the  bed  was  vacated.  The  sacks 
were  washed  once  in  two  weeks  and  the  straw  changed.  Blanks 
c'ts  were  always  clean,  and  frequently  changed.  During  hot 
seasons  the  windows  and  doors  of  the  wards  were  continually 
open.  In  cold  seasons  the  windows  were  opened,  for  a  short 
time,  repeatedly  in  the  day ;  care  being  taken  that  the  sick  in 
th(  ir  beds  were  not  exposed  to  the  direct  currents  of  air.  No 
person  was  i)ermitted  to  spit  on  the  floors  of  the  wan'^.  Spit- 
boxes  were  furnished  every  bed,  and  filled  with  fresh  sand  twice 
n  day,  sometimes  oftener  where  the  patients  expectorated  large- 
ly. Close-stools,  bed  pans  and  urinaries  were  removed  as  soon 
as  employed.  No  culinary  process  was  performed  at  the  hearths 
of  the  sick  wards.  Attached  to  each  ward  was  a  closet,  where 
the  table  furniture,  after  washing,  was  deposited  in  neat  order. 
Each  ward  was  furnished  with  a  large  table,  constantly  covered 
with  a  clean  cloth  of  linen,  the  better  to  ensure  its  cleanliness ; 
on  which  was  placed  a  box  with  a  number  of  little  apartments, 
wherein  were  set  in  order  the  vials  and  medicine  for  the  pa- 
tients, each  vial  and  parcel  labelled  with  directions,  so  as  to 
obviate  mistakes. 


i' 


HOSPITALS. 


243 


Attention  wag  paid  to  the  distribution  of  the  sick.  The  wards 
appropriated  to  infectious,  or  contagious  diseases,  were  less  crowd- 
ed  than  those  occupied  by  patients  with  less  important  com- 
plaints. Surgical  cases  had  rooms  separate  from  the  febrile. 
Venereal  and  itch  patients  were  assigned  to  their  separate  wards, 
and  not  intermixed  with  men  of  different  diseases. 

To  guard  against  infection,  or  obviate  its  generation,  was  of 
the  highefl  imiiortance.  An  infected  ward  was  not  seen  at 
these  points,  where  my  observations  were  made  ;  but  it  required 
unremitted  application  of  the  means  which  were  experienced 
most  etlicient  to  prevent  infection — such  were  the  daily  sanding 
the  floors — ventilating  the  wards — and  frequently  washing  the 
walls  with  lime  and  water. 

Personal  cleanliness  was  also  a  mean  which  promoted  health, 
and  obviated  the  generation  of  new  diseases.  At  Burlington 
hospital,  the  sick,  previous  to  admittance,  «vere  washed  in  tepid 
water,  in  an  apartment  appropriated  to  this  use  ;  then  placed  in 
a  clean  bed  with  a  clean  shirt.  Daily  ablutions  of  the  hands 
and  face  were  ordered.  The  sick  with  febrile  diseases  under 
the  immediate  direction  of  a  surgeon,  were  occasionally  washed 
er  spunged  with  vinegar  and  water,  at  some  seasons.  The  pa- 
tients in  the  hospital  were  shaved  every  other  day,  and  shirted 
twice  in  a  week. 

The  beds  throughout  the  hospital  were  always  in  order  wheth- 
er occupied  or  not.  If  a  patient  left  his  bed  ever  so  frequently^ 
m  the  day,  if  only  for  five  minutes,  it  was  immediately  put  in  or- 
der ;  so  that  the  wards  were  always  in  a  condition  to  be  visited 
or  inspected  by  officers  of  the  army. 

The  inspectors,  generally,  gave  a  few  hours  notice  of  their  reg- 
ular inspections.  This  was  done  more  with  a  wish  that  the  sur- 
geons might  be  present  at  the  time,  than  to  give  opportunity  for 
preparatory  arrangements.  For  the  hospital  department  was  not 
ignorant  that  domiciliary  visits,  or  private  inspections  were  fre- 
quently made  without  the  knowledge  of  the  surgeons ;  also,  con- 
fidential reports  to  government  by  inspectors,  as  a  part  of  a  sys- 
tem of  espionage  instituted  at  the  war  department.  This  was 
told  in  my  hearing  by  an  officer,  when  reproving  one  for  n^ 


'    t. 


I  frr:* 


244 


HOSPITALS. 


gleet  of  duly.  With  (his  Byetem  we  were  not  dissatisfied,  and 
no  officer  will  object  to  it  when  carried  into  effect  without  prcju- 
<Hce,  and  solely  with  a  view  to  promote  good  discipline.  But 
when  entrusted  to  men  who  might  seek  their  own  preferment  by 
a  premeditated  disgrace  of  others,  the  system  was  dangerous  in 
pits  oeration,  by  compelling  the  most  eOicient  officers  to  leave 
the  service  of  the  army. 

The  gentlemen  of  the  hospital  were  not  a  little  amused  and 
pleasantly  entertained  at  one  time,  by  the  conduct  of  an  assist* 
Ant  inspector  of  the  line,  so  little  acquainted  with  the  manage- 
ment and  arrangements  of  a  hospital,  that  he  was  ignorant  of 
what  were  most  fit ;  but  willing  to  exhibit  his  talent  as  a  critical 
observer,  captiously  censured  practices  designedly  adopted  by 
the  director  of  the  hospital,  and  recommended  different  methodg 
most  improper.  If  a  department  require  improvement,  the  offi* 
cers  of  police,  as  well  as  inspection,  should  possess  a  competent 
knowledge  of  every  thing  pertaining  to  it.  It  cannot  be  expect* 
ed  that  officers  of  the  line  of  an  army,  have  a  correct  acquaint* 
ance  with  all  the  appendages  of  a  hospital ;  it  seems  necessary 
then,  that  a  surgeon  be  associated  with  an  inspector  of  the  line, 
when  he  executes  his  duty  of  examining  the  hospital  de- 
partment ;  especially  when  the  establishment  is  exteusive. 

The  hospital  at  Burlington,  during  tive  months  in  succession, 
when  under  my  immediate  direction,  was  not  one  hour  in  a  state 
so  bad,  it  would  not  meet  the  approbation  of  an  inspecting  offi- 
cer who  knew  his  duty.  ThJs  hospital  was  visited  repeatedly 
by  officers  of  the  line,  when  under  the  direction  of  Doctors 
Wheaton  and  Hunt,  and  during  every  period  after  August, 
1813,  was  always  seen  in  the  best  possible  order;  and  deserved- 
ly merited  the  high  encomiums  it  received,  not  only  from  in- 
spectors of  the  army,  but  private  citizens. 

The  more  than  useless  parade  of  prescribing  in  a  dead  lan- 
guage, should  be  dispensed  with  in  hospital  practice.  Physicians 
of  all  nations,  except  the  British,  write  their  prescriptions  in 
their  own  languages.  No  cogent  reason  can  be  assigned,  why 
we  should  continue  to  imitate  a  practice,  which  originated  at  a 
period  of  general  ignorance,  when  learning  ^vag  confined  to  a  few 


1  '   = 


ed, and 
t  preju- 
B.  But 
nent  by 
iroue  in 
to  leave 

Bed  and 
in  assist* 
manage* 
lorant  of 
a  critical 
opted  by 
methods 
,  the  offi* 
ompetent 
)e  expect- 
acquaint- 
necessary 
'  the  line, 
spital  de- 
lve. 

iccession, 
in  a  state 
icting  offi- 
lepeatedly 
Doctors 
August, 
deserved- 
from  iQ* 

dead  Ian- 
[hysiciana 
liptions  in 
Ined,  why 

lated  at  a 
to  a  few 


HOSPITALS. 


24& 


wen,  who  wore  large  gowns  and  full  wigs.  But  since  these  ap- 
pendages of  the  scientific  professions  are  justly  ridiculed,  even  in 
Great  Britain,  where  most  in  use,  and  are  not  adopted  by  gen- 
tlemen of  our  learned  professions,  it  is  time  that  other  practices, 
equally  ostentatious  and  unnecessary,  s  ould  be  treated  with  e- 
<)U!il  contempt.  - 

Prescriptions  and  directiona  in  hospital  practice,  should  be 
plainly  written  in  an  intelligible  language,  on  a  book  left  with 
tlie  nurses  in  the  several  wards ;  by  which,  during  the  absence 
of  the  attending  surgeon,  they  may  govern  themselves,  after  the 
prescriptions  are  made  up.  By  this  improvement,  all  unpleas- 
ant accidents  may  be  avoided. 

During  the  winter  1813-14,  there  was  attached  to  the  hospi- 
ti»'  under  my  immediate  care  at  Malone,  a  faithful  sergeant; 
with  whom  was  intrusted  the  medicine  for  fifty  patients,  with  di- 
rections for  each  in  plain  english.  This  sergeant,  without  any 
assistant,  administered  the  medicine  daily  for  six  weeks ;  and 
executed  this  duty  with  the  greatest  precision  and  punctuality. 

It  would  be  convenient  that  stewards  and  ward  masters  were 
acquainted  with  the  materia  medica,  and  the  several  composi- 
tions employed  in  practice.  Such  aid  during  the  war  was  most 
acceptable,  when  the  hospitals  were  crowded  with  numbers  great- 
er than  the  surgeons  present  could,  with  all  their  industry,  prop*- 
crly  attend.  In  two  or  three  instances,  such  appointments  werei 
made.  It  is  not  unfrequent,  that  students  in  medicine,  who  have 
acquired  a  partial  medical  knowledge,  are  found  willing  to  ac- 
cept such  appointments,  for  an  opportunity  of  further  improve- 
ment. Such  industrious,  ambitious  young  men,  are  highly  use- 
ful in  extensive  hospitals. 

At  the  commencement  of  the  war,  a  young  gentleman,  who 
had  recefved  a  medical  education,  accepted  the  appointment  of 
steward ;  not  being  able  to  obtain  a  better  at  that  period.  He 
acquitted  himself,  in  that  office,  with  so  much  honor  and  fidelity, 
that,  at  the  opening  of  the  second  campaign,  he  received  the  ap- 
pointment of  hospital  surgeon's  mate ;  wherein  his  services  were 
meritorious,  and  met  with  approbation.     ^  .4.. 


I 


i  I 


\      ; 


')       ■' 


KW:y.T 


32 


k\ 


•\  «I»W 


rf! 


»^.. 


Nl 


U6 


HOBPITALS. 


A  registry  of  every  patient  should  be  kept,  noticing  rank,  time 
'^  admittance,  company,  regiment,  casualties,  when  discharged 
service,  >vhen  returned  to  duty,  and  death.  This  regulation  was 
adopted  at  Burlington  in  the  winter  1813-14;  previous  to 
which,  no  sick  records  were  found  at  that  hospital.  The  hospi. 
tal  records  on  the  Niagara,  were  under  no  order.  The  pressure 
of  duty  was  so  heavy  and  unremitted,  that  all  our  time  was  em- 
ployed among  the  sick.  Besides,  in  many  instances,  they  were 
sent  from  their  regiments,  in  an  irregular  manner,  unaccompa- 
nied with  their  description  rolls;  and  this  neglect  of  duty  con- 
tinued in  some  cases,  even  until  the  close  of  war. 

It  is  necessary  that  surgeons  should  preserve  a  record  of  their 
prescriptions,  as  well  as  a  correct  history  of  disenses  which  fall 
under  their  immediate  observation.  These  assist  memory,  im- 
prove practice,  and  establish  method  and  order;  which  are 
highly  important  in  an  extensive  hospital.  At  Burlington  and 
some  other  posts,  this  regulation  was  adopted.  An  abstract  of 
im|>ortant  cases  is  equally  important ;  but  was  only  very  partial- 
ly attended  to  by  the  surgeons  of  our  army.  The  above  regula- 
tions will  not  be  carried  into  practice,  until  the  surgeons  feel 
that  a  neglect  is  an  abandonment  of  duty. 

During  the  winter  1813-14,  at  Burlington  hospital,  Vermont, 
there  were,  at  one  period,  betwt^en  7  and  800  patients,  distribu- 
ted in  40  wards,  nearly  equally  «!!ivided  among  eight  hospital 
surgeons  and  mates.  These  young  gentlemen  felt  themselves 
highly  resfionsible  for  the  state  of  their  respective  wards,  and 
condition  of  the  sick ;  who  were  not  a  little  benefited  by  a  com- 
petition excited  to  excel  each  other  in  their  duty ;  which  was 
manifested  by  daily  improvements,  in  respect  to  cleanliness  aoU 
liccommodations  of  their  patients. 

During  four  months,  my  own  task  was  unremitted;  every 
ward  was  daily  visited,  and  an  equal  share  of  the  prescribing  du- 
ty was  performed  by  myself;  not  a  day  was  granted  for  relaxa- 
tion ;  every  hour  in  the  twenty-four,  except  when  taking  refresh- 
ment and  natural  rest,  found  me  at  the  hospital.    "*  '^'  ".'"  "  ■• 

The  location  of  this  military  hospital  is  most  eligible,  situated 
on  the  highest  bank,  elevated  sixty  or  seventy  feet  above  the 


I  ' 


H0SPITAL8. 


243 


water.  The  toil  of  this  spot  ii  taad  mixed  with  gravel,  dry  and 
hard  at  all  ■eaiuni  of  the  year. 

During  the  campaign  1814,  a  convenient  garden  was  laid  out, 
under  the  direction  of  Doctor  Hunt,  hospital  surgeon.  Tor  the 
benefit  of  the  convalescents  and  invalids,  which  by  thdr  labour 
was  kept  neat  and  in  gooil  order , 

The  interior  of  this  hospital  has  been  already  noticed,  the  ex- 
terior was  not  less  attended  to.  In  an  a(\joining  house,  the  sur- 
geons were  accommoilated  with  comfortable  rooms,  where  one 
or  more  always  remained. 

The  wa  'Is  of  this  hospital  were  regularly  swept  and  put  in  or* 
der  by  sun-rise  through  the  year.  The  wards  were  visited  by 
their  several  surgeons  in  the  summer  months,  at  eight  o'clock  in 
the  morning,  in  the  winter  at  nine.  Previous  to  these  hours, 
the  patients  had  breakfasted.  The  rooms  were  not  only  in  per- 
fect order,  but  every  patient  was  found  in  his  own  lodging. 
While  the  surgeons  were  making  their  prescriptions,  silence  was 
preserved.  The  prescriptions  were  taken  by  the  attendants  to 
the  dispensary,  where  they  were  immediately  made  up  by  the 
apothecaries.  During  the  winter  1813-14,  four  apothecaries 
were  constantly  employed  in  their  appropriate  duty.  . , 


FLYING  HOSPITALS. 

It  has  been  found  necessary,  during  active  operations  of  au 
army,  to  attach  to  it  flying  hospitals,  so  denominated,  because 
they  are  subject  to  repeated  removals  during  a  campaign.  As, 
at  all  times  they  should  be  in  preparation  to  receive  and  accom- 
modate the  sick  and  wor.aded,  so  they  have  or  should  have  an- 
nexed to  them  a  complete  corps  of  the  hospital  stafiT,  with  an  ade- 
quate numl)er  of  attendants,  enlisted  solely  for  that  employment. 
Instead  of  which,  on  the  Niagara,  we  were  under  the  necessity 
of  selecting  stewards  and  ward-masters  from  the  line  ;  and  wece 


I  j 

11; 


1'1 


■i'' 


■  7i 


1 


248 


1I08PITALK. 


ilopondent,  in  tlio  lirat  instnnco,  upon  detnitx  Trom  t1i<»  nrtny  for 
our  nttenilanis,  who,  unfi»fluMftl<'ly,  wen*  mi'n  of  incom  ct  hiibils, 
ami  bad  (ItBitosilions.  It  wns  uiulrrHlcxNl,  wlinn  (he  dt'tailfl  wrre 
made,  such  were  desif^nedly  pelecled  Tor  this  (wliinh  was  couHid- 
erod)  permanrnt  duty,  ns  were  ohalinate  and  ungovernable; 
men  upon  Avhom  no  «lepender.(;e  could  be  placed.  Soilly  dFx- 
posed  were  they  to  perTorm,  aiid  totally  uncpialified  to  execute  the 
duty  assigned,  they  were  immediately  ordered  to  rejoin  I  heir 
several  corps.  Thus  disappointed,  no  further  requisitioufi  were 
made  on  the  adjutant  general  of  the  army  for  attendants  during 
the  war ;  but  they  were  selected  from  the  convalescents,  who 
were  retained  for  this  service.  From  among  these  we  were  al- 
ways able  to  obtain  men  of  happy  disjiositions,  who  were  kind 
to  the  sick,  and  whose  unremitted  attention  was  a  constant 
pledge  of  their  fidelity. 

Large  tents  were  improved  as  field  hos[titals  during  cam- 
paigns,  each  of  which  was  sufliciently  capacious  to  accommodate 
16  or  18  patients.  From  the  Ist  of  June  to  the  last  of  Se|)lpm- 
ber,  hospital  ttiits  v/ere  comfortable  accommodations  for  the 
sick,  in  the  northern  district;  far  preferable  to  common  dwell- 
ing-houses. Tents  require  but  little  care  and  attention,  to  pre- 
serve them  in  a  state  of  cleanliness. 

It  is  of  importance  that  a  suitable  position  be  chosen  for  au 
hospital  encampment.  The  ground  should  be  grnvell}',  hard 
and  dry.  Such  were  the  lands  on  which  the  hospital  was  estab- 
lished in  1813,  at  Lewistown.  Drains  or  ditches  should  be  cut 
to  take  off  the  rain  water;  and  the  tents  should  be  removed  i\» 
often  as  two  weeks  from  the  old  ground  to  fresh.  Frequent 
changes  prevent  the  generation  of  infection.  Ground  floors 
should  be  daily  scraped  and  swept.  On  the  Niagara,  these  dn- 
ties  were  rigidly  enforced.  The  flying  hospital  at  Lewistown, 
was  continually  preserved  in  so  healthy  and  pure  condition,  that, 
where  the  monthly  reports  exceeded,  at  one  period,  600  men,  no 
new  disease  supervened.  Among  some  hundreds  of  convales- 
cents, who  were  discharged  the  hospital  for  light  duty ;  only  three 
were  returned  to  the  hospital  from  the  first  of  July  until  the 
last  of  September.  Such  were  the  state  of  the  hospital  awl 
healthy  situation  of  that  encampment 


HOSPITALS. 


^4tt 


Arter  seleclinii;  luitalile  ground  and  pitching  tentt,  the  firat 
care  U  to  dis;  linka,  nt  n  |iro|i«r  dietHnCR  from  the  iMiaiiital,  munt 
npc  inry  r«c<>|ititclr8  Tor  all  kiuUs  of  (ilth,  and  which  ihould  he 
daily  covrrrtl  u  it  li  earth.  •     •  -i '-i       ,'   . 

Kilchcns  are  moat  necessary  app«nda);es  to  a  field  hospital. 
They  are  fxpeditioiiely  ronstriicled  with  stones  or  sods  of  earth, 
in  shajie  of  the  fire-place  of  a  chimney.  The  o|ieniiii;  in  front 
nnd  s'lJes  is  defended  from  wind  hy  a  barrier  composed  of  pliant 
bnuiches  interwoven  witli  stakes  fixed  in  the  ground,  and  roofed 
over  with  houghs  or  bark  of  trees  to  |)rotect  the  cooks  from  the 
rain  and  the  sun's  rays. 

Ovens  arc  also  conveniently  constructed  with  stones,  If  at 
!inn«l,  or  Carih  supported  by  round  tim!>er  in  a  square  form  of 
suitable  (iimenHions,  locked  into  each  other  at  the  corners.  Tim 
floors  of  the  ovens  are  of  flat  stones,  or  clay,  which  arc  shaped  by 
«mall  dry  woo<l  covered  with  bark  of  trees,  and  plastered  over 
with  a  thick  coat  of  clay,  worked  to  a  consistence  which  is  nec- 
essary for  bricks.  In  this  state  they  are  suffered  to  remain,  de- 
fended from  rains  by  bark  roofs,  until  hardened  by  wind  and  the 
heat  of  the  sun.  Fire  is  then  set  to  the  wood  within,  which 
supports  the  coat  or  covering  of  the  ovens;  which,  l)y  burning, 
becomes  hard  and  durable.  To  Colonel  Pinknev  I  feel  myself 
indebted  for  the  above  expeditious  method  of  erecting  field  ov- 
ens, important  to  be  known  in  an  army,  more  especially  when 
suitable  stones  for  their  formation  are  not  to  be  found  in  its  vi- 
cinity. 

Large  barns  may,  at  a  small  expense,  be  made  the  most  com- 
modious field  hospitals,  during  the  heat  of  the  summer  months, 
from  the  first  of  June  to  the  last  of  Octolter.  At  Lewiatown,  in 
the  vicinity  of  the  hospital  encampment,  two  barns,  forty  feet 
square,  were  fitted  for  hospitals.  Floors  of  inch  plank  were  laid 
on  joists  raised  on  a  level  with  the  cills  of  the  barns.  In  each  of 
these  were  placed  one  hundred  men ;  but  they  were  too  much 
crowded.  As  soon  as  tents  were  furnished,  more  room  was  giv- 
en by  removing  a  part  of  them  to  tents ;  so  that  sixty  patients 
were  comfortably  accommodated  in  each  barn.  These  were 
the  most  eligible  summer  hospitals  wiiich  I  saw  during  the  cam- 


if 


.i;i 


I 


1 


II 


1  M 


'i  fn 


V        :.   i 


jlj 


I  I 

iV 


250 


HOSPITALS. 


r   :l 


\ 


paigns.  The  sick  and  wounded,  here,  were  as  comfortably  lodg- 
ed as  they  would  have  been  in  a  dwelling  house ;  and  much  les« 
incommoded  by  the  heat  of  the  weather,  which  was  very  oppres* 
sive,  at  times,  during  the  months  of  July  and  August.  Through 
the  spacious  and  lofty  rooms,  by  means  of  large  double  doors  on 
each  side  of  the  barns,  a  free  circulation  of  air  was  admitted ; 
which  was  not  only  grateful,  but  salubrious. 

Bunks  were  furnished  the  sick ;  but  as  bunks  made  of  boards 
are  not  conveniently  transported,  at  even  a  short  distance,  the 
movement  of  a  flying  hospital  would  be  Hicilitated,  if  it  were  fur- 
nished with  canvas  bed-bottoms,  constructed  with  loops  on  the 
sides,  through  which  pass  poles  for  their  support.  The  bed-bot< 
toms  arp  supported  by  stakes  drove  into  the  earth  with  a  fork  on 
the  top  to  support  the  poles,  to  which  the  bottoms  are  attached. 
These  beds  may  be  put  up  in  a  few  minutes.  They  are  less  ex- 
pensive than  bunks  of  wood ;  which,  when  the  hospital  removes, 
are  generally  left.  Furnished  with  these,  no  other  bedding,  or 
straw,  except  two  blankets,  are  necessary  in  hot  Aveather.  Dur- 
ing the  campaign  of  1813,  1  furnished  myself  with  one  of  i^hese 
bed-bottoms,  upon  which,  lodging  was  easier  and  much  ccer 
than  on  a  sack  filled  with  straw  in  a  bunk  of  wood. 

As  the  events  of  military  operations  are  doubtful,  to  facilitate 
the  movement  of  the  hospital  department  attached  to  an  army,  it 
should  be  furnished  with  a  number  of  waggons  and  teams,  so  as 
not  to  he  immediately  dependent  on  the  Qn'-.ter-Master's  depart- 
ment, when  requisite  either  to  take  the  wounded  from  the  field 
of  battle,  or  transport  the  sick  in  case  of  a  retrograde  march,  or 
remove  invalids  after  having  recovered  from  wounds  to  a  remote 
hospital.  The  flying  machines,  called  volatU.es,  drawn  by  bur* 
ses,  (an  improvement  of  Larrey,  chief  surgeon  of  the  French 
army)  are  useful  in  open  countries,  where  a  corps  is  assigned  to 
accompany  them  on  the  field  of  battle,  upon  Larkey's  plan. 

Flying  hospitals,  during  compaigns,  arc  often  temporary. 
Three  new  establishments  were  made  on  the  Niagara  in  1813, 
in  consequence  of  removes.  These  removes  and  establishments 
are  attended  with  trouble,  anxiety,  and  much  labour  to  the  sur- 
geons, as  well  as  distress  and  pain  to  the  patients,  especially  over 


HOSPITALS. 


251 


bad  roads.  The  movement  or  250  sick,  Trom  Lewistown  to 
Williamsville,  a  distance  of  40  miles,  was  painriit  to  the  specta- 
tor— it  aggravated  the  didonlers  of  many,  and  caused  the  death 
of  some.  This  was  performed  the  last  of  October.  There  were 
but  two  alternatives,  either  to  erect  ho8i>itals  from  the  rough  tim- 
ber of  the  forrests  in  the  vicinity  of  Lewistown,  or  occupy  the 
barracks  built  at  Williamsville  (eleven  mile  Creek)  by  General 
Smyth's  division.  The  first  required  too  much  time  to  com- 
plete, at  this  advanced  season  of  autumn ;  the  last  was  consider- 
ed'the  most  eligible,  as  the  men  would  have  less  ha.  aips  to  en- 
dure by  a  remove  to  houses  already  erected,  than  by  necessary 
exposure,  while  new  huts  were  building.  The  barracks  at  Wil- 
liamsville wanted  considerable  repairs ;  but  in  a  short  period 
were  rendered  comfortable.  During  this  remove  Doctor  Wiht- 
BiDGE  was  my  only  assistant. 

The  February  following,  in  most  severe  weather,  the  removal 
of  450  sick,  from  French  Mills  and  Malone  to  Burlington,  dis- 
tances of  75  and  93  miles,  through  a  dreary  wilderness,  with  few 
improved  spots,  was  a  scene  much  to  be  deplored. 

To  establish  an  hospital,  and  render  it  a  comfortable  asylum 
for  the  sick  and  wounded,  is  a  work  whicli  requires  considerable 
time ;  and  while  in  preparation,  their  sufferings,  frequently,  are 
extreme.  To  support  it  in  good  order,  requires  unremitted  du- ' 
ly  and  rigid  attention.  It  often  happens  as  soon  as  an  establish- 
ment is  completed,  it  is  ordered  to  be  broken  u;),  tlie  sick  remov- 
ed to  a  distant  position,  where  the  business  of  forming  a  new  es- 
tablishment is  repeated.  Such  was  a  part  of  our  duty  from  the 
commencement  of  the  first  campaign  to  the  close  of  tlie  war.  It 
were  unreasonable  to  expect  that  such  temporary  infirmaries 
could  be  made  to  assume,  in  a  few  days,  that  order  and  regulari- 
ty which  are  seen  in  old  established  hospitals. 

It  is  much  less  difficult  to  frame  a  system  in  the  closet  for  the 
well  ordering  of  a  department,  than  put  it  into  execution  in  the 
field ;  especially  in  a  country  where  materials  for  its  organiza- 
tion are  with  difficulty  obtJ»'""d  ;  where  ingenuity  and  industry, 
as  well  as  science,  aie  called  into  requisition  to  give  their  aid. 
Sui^eons  and  physicians  may  write  admirably  well  upon  wounds 


t 


I, 


'I 


'  h 


I 


r       ' 


'i 


I 


7^ 


^62 


HOSPITALS. 


II 


ami  diseases,  and  describe  correctly  modes  of  treatment  and 
methods  of  practice,  who  are  unable  to  perform  the  simplest  op- 
eration, or  prescril)e  with  judgment  at  the  bed  side.  Men  who 
have  never  witnessed  an  action,  nor  seen  an  encampment,  can 
with  adroitness  manoeuvre  an  army  on  paper,  beat  his  enemy 
and  cluim  all  the  honours  of  war.  Take  a  man  educated  in  a 
city,  and  locate  him  in  a  wilderness,  he  would  starve.  As  ex- 
amples make  stronger  impressions  on  the  mind  than  precepts ;  so 
the  manner  in  which  a  thing  has  been  executed,  is  more  durable 
on  the  memory,  than  systematic  rules  and  regulations;  which, 
under  all  circumstances  and  at  all  times,  cannot  be  followed. 

The  Physician  and  Surgeon  General  to  the  army  directed, 
that  in  all  instances  where  the  hospital  department  was  not  sup- 
plied with  a  sufficient  number  of  the  hospital  staCT  to  execute  its 
requisite  duties,  the  directors  of  hospitals  should  require  a  detail 
from  the  regimental  surgeons  for  assistants.  The  above  regula- 
tion was  made  witl'out  reflecting  th^t  the  increased  duty  in  hos- 
pitals immediately  attached  to  the  army,  did  not  lessen  that  of 
regimental  surgeons  in  their  respective  regiments.  There  were 
times  when  the  hospital  mates  were  ordered  to  perform  regiment- 
al duty,  while  at  the  same  period  the  hospital  department  was 
deficient  of  medical  aid.  From  Lcwistown,  two  hospital  mates 
were  ordered  to  Fort  George  by  the  commanding  general,  which 
reduced  the  number  of  mates  attached  to  myself  to  two,  at  a  pe- 
riod when  the  hospital  returns  of  sick  and  wounded  counted  be- 
tween six  and  seven  hundred.  Remonstrances  against  t  ..e  im- 
propriety of  the  order  had  no  influence  to  countervail  ito  execu- 
tion. It  was  assigned  by  the  Commander  in  Chief  as  a  reason 
for  this  procedure,  as  the  army  expected  an  immediate  action,  it 
Avas  important  the  destitute  regiments  should  be  furnished  with 
surgeons.  At  another  F)t:fiou,  \>ItO<?  *Mf;  siok  in  the  general  hos- 
pital numbered  730,  the  only  mate  pieR'^nt,  capable  of  duty,  was 
ordered  into  the  line  of  the  army,  when  I  was  left  to  perform 
the  whole  duty.  This  last  circumstance  occurred  immediately 
subsequent  to  directions  from  the  Physician  and  Surgeon  Gener- 
al to  demand  from  the  line  additional  medical  aid ;  these  direc- 
tions were  the  consequence  of  my  reports  to  him,  that  the  hoa- 


hi 


HOSPITALS. 


253 


pital  department,  under  my  immediate  charge,  had  not  sufficient 
asaistants  to  prescrilte  for  the  sick  and  do  them  justice. 

These  were  embarrassments  resulting  from  existent  regula- 
tions, which  located  ttie  P.  and  S.  General,  with  whom  was 
lodged  the  sole  authority  of  distributing  the  hospital  staff  of  the 
army,  at  a  distance  of  five  hundred  miles  from  the  scene  of  actu- 
al service ;  who,  consequently,  could  not  have  been  fully  ac- 
4}uainted  with  the  real  state  of  the  hospitals ;  and  could  not 
have  known  when  medical  aid  was  most  necessary,  nor  the 
changes  the  department  was  subjected  to,  in  consequence  of  un- 
foreseen movements  of  the  army.  Every  new  disposition  made 
by  the  commander  in  chief  could  not  have  been  anticipated  at  a 
remote  distance  from  the  army ;  nor  could  it  have  been  known 
that  a  division  of  the  army,  upon  suddenly  changing  its  position 
l»y  taking  up  its  line  of  march  to  a  distance  of  two  hundred  miles 
or  more,  would  take  with  it  the  principal  part  of  its  medical 
staff,  and  leave  031  sick  under  the  charge  of  one  hospital  surgeon 
and  one  mate  capable  of  duty ;  and  only  one  surgeon  to  two  reg- 
iments of  the  brigade  which  remained ;  and  which,  momently* 
expected  an  attack  from  a  vastly  superior  and  overwhelming 
force  of  the  enemy*  *   d' ' 

These  evils  did  not  spring  from  an  injudicious  distribution  oT 
the  hospital  department,  but  from  a  defect  in  the  general  system* 

Established  hospitals  should  have  had  surgeons  permanently 
located  to  them,  who  should  not  have  been  sul^jected  to  a  remo- 
val from  one  post  to  another.  The  moving  army  should  have 
had  a  distinct  hospital  stafiT  attached  to  it,  to  accompany  it  is 
all  its  movements;  which  should  have  been  furnished  with  the 
means  of  establishing  a  field  hospital  as  soon  as  the  army  took  a 
position ;  and  necessary  transportation  to  advance,  or  retrograde, 
as  circumstsnces  might  require.  An  arrangement  upon  the 
above  plan  would  have  obviated  confusion,  and  would  not  have 
left  the  sick  destitute  of  medical  aid,  at  any  point. 

It  has  been  already  observed,  that  soldiers  in  the  hospital,  fre- 
quently, attempted  to  impose  on  the  surgeons,  after  they  were  fit 
for  duty.  Such  impositions  were  easily  detected  by  a  little  ob- 
servation.    Some  of  these  artful  men  hud  the  power  of  assuming 

3? 


ii| 


.'i!' 


•1 , 


i  * 


f  I  '} 


ill 


S'l 


254 


HOSPITALS. 


■I 


Hi 


I 


i 


a  countenance  of  extreme  distress,  and  even  despair,  whenever 
they  pleased.  The  best  method  1  experienced  was  not  to  treat 
the  men  with  severity,  but  to  put  them  off,  wilh  a  view  to  take 
their  cases  into  consideration,  and  visit  them  In  their  wards  at  a 
time  they  least  expected ;  when,  being  taken  off  their  guard,  de- 
ceptions were  more  easily  detected.  I  have  seen  a  man  come 
to  me  limping  and  always  appeared  lame,  in  and  about  the  hospi- 
tal, but  when  permitted  to  depart  from  it  a  mile,  could  walk  perfect- 
ly well.  The  following  case  is  here  published  at  large  on  account 
of  its  singularity. 

During  the  month  of  September,  1812,  an  enlisted  soldier,  who 
had  been  admitted  into  the  hospital  on  account  of  some  indispo- 
sition, presented  himself  to  me,  requesting  a  certL^oate  of  inva- 
lidity to  perform  duty,  in  order  to  obtain  his  discharge  from  ser- 
vice. His  countenance  not  exhibiting  marks  of  disease,  led 
me  te  enquire  the  reasons  he  should  make  such  a  request,  espe- 
cially, as  he  had  not  performed  any  duty'in  the  field,  and  had 
not  been  previously  enlisted  more  than  three  months.  For  some 
time  he  hesitated  to  reply ;  at  last  said  he  was  not  a  man.  Up- 
on examining  his  countenance  with  more  attention,  I  observed  to 
him  he  could  not  be  a  woman.  He  said  he  was  not,  but  would 
shew  me  what  kind  of  a  being  he  was.  Upon  examination,  it 
was  discovered  he  did  not  possess  tl>e  characteristic  marks  of  ei- 
ther the  masculine  or  feminine  gender ;  therefore  I  was  under 
the  necessity  of  considering  him  as  one  of  the  few  of  the  animal 
creation,  as  belonging  to  the  neuter.  An  hermaphrodite  is  an 
animal,  which,  agreeably  to  its  import,  unites  both  sexes — thia 
person  had  not  the  characteristic  marks  of  either.  The  testes 
and  penis  were  wanting ;  in  place  of  the  scrotum  there  was  a 
fleshy  excressence  which  was  not  pendant,  but  appeared  similar 
to  the  scrotum  of  a  child ;  in  place  of  the  penis  there  was  a 
fleshy  elongation  similar  to  the  teat  of  a  cow,  about  two  and 
half  inches  in  length,  destitute  of  a  urethra  ;  immediately  under 
which  was  the  urethra  of  the  bladder.  There  was  no  such  part 
lo  l>e  found  as  a  vagina.  When  I  conversed  with  him  respect- 
ing venereal  passions  and  sexual  intercourse  ;  of  the  first,  he  said 
he  had  none,  of  the  last,  he  had  no  knowledge  except  what  be 


HOSPITALS. 


861* 


had  occasinally  "  ^arnt  from  those  belter  experienced  than  him- 
self.    Upon  examining  his  countenance  more  particularly,  (al- 
though he  had  a  thinly  scattered  beard,   being  over  the  age  ol 
thirty)  it  exhibited  neither  the  expression  of  masculine  nor  fern- 
nine.     It  wanted  the  hold  front  of  the  man,  and  the  soft  features 
of  the  woman ;  the  spirit  and  animation  of  Iwth.    There  appear- 
ed about  him  nothing  revengeful,  but  every  thing  inotfensive ; 
something  of  low  cunning  and  deceit.    This  being  was  filthy  ia 
his  ;reneral  appearance,  and  to  me  extremely  disgusting ;  more 
especially  after  his  character  was  known. — A  being  abhorrent 
to  hura.in  nature ;  having  nothing  about  him  which  could  ex- 
cite the  passions  of  eitlier  sex.     He  had,  however,  sufficient 
address   to   impose  upon   the   officer  who   enlisted  him ;  wil- 
ling to  receive  a  premium,  but  as  willing,  after  having  obtained 
Ills  bounty,   to  exhibit  pretensions,  whereby  he  might  be  dis- 
charged the  service.     With  his  physical  defects,  a  moral  turpi- 
tude, as  want  of  honour  and  rectitude,  was  very  conspicuous. 

The  distresses  incident  -to  an  army,  however  bad,  and  fre- 
quently as  great  as  can  be  endured,  are  always  exaggerated  at  a 
distance  from  the  scenes  of  action.     High  coloured  representa- 
tions produce  on  the  public  mind  sensations  as  varient,  as  are 
political  views  respecting  measures  pursued.     Those,  who  have 
not  the  means  of  obtaining  a  correct  knowledge  of  facts,  are 
among  the  first  to  censure ;  while  one  sincerely  lanoents,  another 
rejoices  at  every  disaster.     Could  all  become  eye-witnesses  how 
much  with  spare  means  is  executed,  the  tongue  of  slander  and 
detraction  would  be  converted  to  vehicles  of  praise  and  admira- 
tion.    For  the  reputation  of  the  establishments  where  orders 
have  called  me,  it  is  my  duty  to  state,  that  visitors  from  remote 
parts  always  expressed  astonishment,  on  finding  the  condition  of 
the  sick  far  more  comfortable  than  was  expected  from  represen- 
tations received;  while  it  gave  me  much  satisfaction  to  improve 
every  opportunity  to  undeceive  all,  who  were  prejudiced  by  mis- 
representations. 

It  is  with  peculiar  pleasure  that  I  call  to  mind  the  gentlemen;, 

with  whom  I  had  the  honour  to  serve,  at  various  points,  on  the 

Irontiers  during  the  war.    Particularly,  the  names  of  VVheaton^ 


I: 

I 


I  ■! 


i  1 

I     I 


I'i 


i  t 


i\^    > 


^U'^Ciiir..^  -..v.  J.'  ■ 


Y 


rrw:^ 


25a 


HOSPITALS. 


')  » 


M 


^  m 


Hunt  and  Lovell,  of  the  hi^jiheat  grade  of  surgeons ;  the  first  et^ 
whom,  my  predecessor  at  Burlington,  directed  lliat  estaltlishmeni 
very  creditable  to  himself;  from  whom  the  hoapitul  came  under 
my  charge  in  high  order.  To  Doctor  Hunt,  who  succeeded  me 
at  that  post,  the  most  liberal  encomiums  are  due.  My  acquaint- 
ance with  the  last  gentleman  being  more  extensive,  gave  me  au 
opportunity  more  fully  to  appreciate  his  merits  as  director  oT 
that  establishment;  which,  from  its  infancy  to  tho  close  of  tlie 
campaigns,  had  h  claim  to  pre-eminence. 

I  have  had  frequent  occasion  to  respectfully  mention  Doctoc 
Lovell  in  the  course  of  these  sketches.  His  frequent  reports, 
one  of  which  is  conjmunicated  at  large,  bespeak  an  accurate  and 
discriminating  mind.  As  au  operative  surgeon,  be  is  inferior  to 
none. 

In  a  particular  manner,  my  acknowledgments  are  here  expres- 
sed to  the  medical  gentlemen  of  the  second  and  subordinate 
grades,  with  whom  I  was  associated  at  various  periods.  Among 
the  Qrst  are  Surgeons  Day  and  Wilson  ;  by  whose  exact  system 
of  police,  the  hospital  establishment  at  Burlington  was,  in  the 
first  instance,  reduced  to  order.  Surgeon's  Mates  Wuitribge, 
Van-Hovenbur6h,  PuacELL,  March,  Walker,  Wallice,Van- 
Hov,  RussEL,  Trevet  and  Russel,  severally  claim  my  high 
regards.  To  all  these  gentlemen  I  shall  ever  feci  attached  by 
the  strong  ties  of  friendship.  To  their  aid  and  assistance,  in- 
dustry and  economy,  close  application  and  unremitted  duty,  tlie 
hospitals,  at  every  point,  where  orders  called  my  attention,  owe 
their  celebrity, 

1  recognize  with  pleasure  the  urbanity  of  Doctor  Buli/,  Hos- 
pital Surgeon  ;  although  not  immediately  associated  with  him  iu 
duty,  yet  his  acienti&c  knowledge  entitles  him  to  jny  high  res- 
pect. 

It  is  with  peculiar  satisfaction,  I  recollect  the  good  state  of 
some  of  the  regimental  hospitals,  particularly  that  under  the 
charge  of  Doctor  Brunough,  now  Hospital  Surgeon  ;  and  those 
of  Doctors  Dlnham,  of  the  light  artillery,  and  Lawson,  of  tht 
8lh  regiment,  at  Plalt^^inirgh. 


HOSPITALS. 


659 


There  are  many  meritorious  gentlemen  of  the  medical  staff, 
both  of  the  ho8|)ital  department  and  line  of  the  army,  whose 
names  have  not  been  recognized  in  these  sketches.  These 
gentlemen  have  not  been  particularly  noticed,  because  my  cir< 
cumscribed  observations,  embracing  only  those  associated  with 
me  in  their  duty,  at  different  periods,  precluded  me  from  that 
critical  knowledge  so  necessary  to  appreciate  their  superior 
claims.  Of  their  services,  the  army  has  reaped  the  benefits; 
of  their  merits,  the  nation  will  long  have  a  recollection. 

Injustice  to  Doctor  Le  Barron,  Apothecary  General  of  the 
army,  whose  civilities  will  always  be  preserved  in  grateful  recol- 
lection, it  is  with  pleasure  we  acknowledge,  he  execuiicd  his  du- 
ty with  promptitude  and  fidelity.  I  have  the  fullest  (vidence, 
that  the  defect  of  supplies  for  the  hospital  department  on  the  Ni- 
agara iu  1813,  was  not  occasioned  by  his  neglect;  as  they  were 
diverted  on  their  route,  from  the  Niagara  frontier  to  Sackett*s 
Harbour,  by  superior  authority.  For  the  deficiency,  at  French 
Mills,  he  was  not  censurable;  no  person  could  have  antici- 
pated the  unaccountable  waste  of  property  on  the  St.  Lawrence. 
To  Doctor  Low,  Assistant  to  the  Apothecary  General,  who 
was  attached  to  the  division  of  the  army,  where  orders  called  my 
services,  many  encomiums  are  due.  In  addition  to  his  appro- 
priate duty  of  issuing  stores,  he,  at  all  times,  volunteered  his  ser- 
vices in  the  hospital ;  and  was  considered,  in  point  of  abilities, 
among  the  most  efficient  surgeons  of  the  army. 


u 


i5 


H 


:n 


!|      I- 


'T/^^ 


/7^ 


■■i 


.  *         !    *     ■-     »  1,7 


OFFICIAL  LETTERS, 

WHICH  ARE  ILLUSTRATIVE  OF  ORSKRVATIONS,  ADDU. 
CED  IN  THE  PRECEDING  WORK. 


NUMBER  I. 


1 1 

General  Hospital  Malonc,  Januan/  31,  1814. 

To  Doctor  Le  Barron,  Apothecary  General  of  the 

Army. 

Sir — Your  letter  of  the  20th  instant  was  this  day  received. 
In  answer  to  which  I  have  to  state,  that  your  assistant,  surgeon 
Low,  upon  reporting  himself  to  the  Commander  in  Chief,  with 
his  instructions  from  you,  was  directed  to  perform  duty  under  my 
'orders  at  this  place.  As  the  hospital  stores  addressed  to  him  had 
not  arrived,  and  having  but  one  mate  doing  duty  with  me  at  this 
post,  his  services  were  necessary  in  the  hospital.  Since  which, 
having  been  advised  the  hos|)itaI  stores  had  arrived  at  French 
Wills,  Doctor  Low  was  released  from  duty  here,  and  ordered  to 
take  charge  of  the  stores  and  medicines,  in  conformity  to  your 
instructions ;  and  is  now  at  the  Mills  issuing  stores  and  medi- 
cine to  the  several  regiraenls.  As  soon  as  the  regiments  have 
received  their  supplies,  more  especially,  as  soon  as  the  sick  at 
the  Mills  can  be  accommodated  at  Malone,  Doctor  Low  will  be 
ordered  to  this  post,  where  he  will  have  an  opportunity  to  do 
hospital  duty.  This  is  agreeable  to  his  wishes,  as  well  as  mine  ; 
as  he  is  very  attentive  to  his  dut}"",  and  a  young  gentleman  of 
pleasing  manners. 


OFFICIAL  LETTERS. 


259 


The  Commnnder  in  Chief  Ivis  selected  thii»  place  as  hcing  tho 
most  eligible  situation  fur  a  general  hospital ;  especially  hi  the 
army  may  not  e^main  a  long  time  in  their  firesent  cantonment 
at  the  Mills;  and  U|ion  retiring  From  that  post,  the  sick  must  he 
transported  to  a  more  secure  position,  remote  from  the  excursions 
of  the  enemy.      .  i-   .  • , 

In  consequence  of  my  frequent  removals  at  (he  close  of  the 
last  year,  the  reports  of  sick,  and  estimation  of  su|>{>lies  for  the 
present  year,  were  to  have  been  forwarded  to  the  surgeon  gen- 
eral of  the  army,  by  Doctor  Ross  from  the  Mills,  and  by  Doctor 
Pkntegrass  from  Platts')urgh. 

From  some  cause,  the  hospital  stores,  which  accompanied  the 
expedition  down  the  river  St.  Lawrence,  were  not  properly  se- 
cured. They  were  either  consumed  by  the  troops,  damaged,  or 
lost.  Many  articles  were  not  to  be  found,  which  were  put  on 
board  the  flotilla,  and  were  not  accounted  for,  when  the  army 
arrived  at  French  Mills.  It  is  now  ascertatned,  that  no  |)er> 
son  was  charged  with  the  care  of  them  ;  it  appears  they  were 
promiscuously  place<!  on  board  the  boats,  wherever  room  fo^ 
their  reception  could  be  found.  It  has  been  said,  the  quantities 
lost  were  amply  sufficient  for  the  army  through  the  winter. 
(This  estimation  is  not  incorrect,  judging  from  the  invoice  of 
stores  ordered  on  board  the  flotilla,  which  was  shewed  me  by 
Doctor  Ross.) 

I  wish  to  impress  upon  you,  (he  necessity  of  furnishing  the 
hospital  with  a  larger  supply  of  rice.     This  article,  in  a  particu- 
lar manner,  is  adapted  to  the  forms  of  the  prevalent  diseases  of 
the  army,  diarrhoea,  and  dysentery. 
Very  respectfully, 

your  humble  servant, 

JAMES  MANN, 

Hospital  Surgeon^ 


Hj 


'  \i: 


'H 


i  i\ 


1! 


.>tV-    ', 


li 


HBO 


OFFICIAL  LETTERS. 


NUMBER  II. 


General  Hospital  Malone,  February  1,  1814* 
To  Major  General  Broavn,  at  French  MiiiLs. 

Rr.HPECTED  Sir — It  is  my  duty  to  state  to  you,  the  lick,  sent 
to  this  [ilacr  yestehliiy,  were  not  all  accorapanie«l  with  the  reg- 
ular r<>p<>rt8  required  by  the  rules  of  the  hospital  department. 
Consequently,  the  surgeons,  annexed  to    ■  regiments,  are 

reported  as  having  neglected  their  duty.  Similar  neglects  and 
Inattentions  have  been  often  overlooked.  The  service  requires 
a  more  punctual  attention  to  duty.  Being  unacquainted  with 
the  names  of  the  surgeons  attached  to  those  regiments,  I  am  ua* 
able  to  point  out,  at  this  distance,  the  delinquents.  Those  gen* 
tiemen  are  undoubtedly  known  to  you.  It  is  important  that  the 
surgeons  of  the  army  strictly  obey  the  rules  and  regulations 
pointed  out  by  the  Surgeon  General;  and,  during  his  absence, 
those  which  may  be  enjoined  by  the  senior  hospital  surgeon 
present. 

Yesterday,  I  had  the  honor  to  state  to  you,  no  provisions  have 
been  made  Tor  a  larger  number  of  sick  than  we  have  at  present. 
The  A.  Q.  M.  General  will  not  take  upon  himself  the  respon* 
sibiity  of  quartering  them  upon  the  inhabitants.  All  the  sick 
now  here,  are  not  as  yet  made  cortifortable.  It  is  my  duty 
further  to  state,  that  out  of  the  number  sent  here  yesterday,  four 
literally  died  with  colJ ;  having  not  a  suflficient  quantity  of 
cloathing  and  blankets,  to  render  them,  in  their  debilitated  con- 
dition, comfortably  warm.  Many  of  vhem  are  destitute  of  ap- 
parel. The  reputation  of  either  our  government,  or  the  offi- 
cers, who  have  the  immediate  command  of  the  troops,  is  daily 
suQering  among  the  citizens,  in  consequence  of  the  distresses  to 
which  the  soldiers  are  subjected.  Humanity  shudders  at  the 
appearance  of  these  unfortunate  men.  Cannot  the  officers  of 
the  line  be  stimulated  to  pay  some  attention  to  their  mck? 


OFFICIAL  LETTERS. 


261 


t)o  turgeonit  or  ro(:;imcnt8  exercise  all  their  tnlcnts  to  nlleviato 
the  wretched  condition  uf  thoBc  intnistrd  to  their  care?  It 
aeeinn  m  if  their  only  nnxiely  wa»  to  pnHB  theni  o(T  their  own 
hnndff,  indilTerent  to  the  m:tnner,  rct;ardlero  of  ill  consecpien^ 
cn«,  provided  Ihey  do  not  make  theinBelves,  immediately,  ac- 
countable for  the  deaths  which  follow. 

Doctors  LovEi.i.  and  Wooubi'ry  are  the  only  sur^com  of  re^- 
iments,  who  have  sent  with  their  sick  regular  reports.  It  is  ex- 
pected VvAt  all  the  sick  sent  to  the  hospital  be  furnished  with 
(hitir  deb".riptive  lists ;  noticing  their  diseases,  time  wliea  taken 
down,  and  the  j^eneral  method  of  treatment.  •  i 

With  sentiments  of  high  respect,  I  am,  Sir,  .       i 

your  most  obedient  and  very  hura!)le  servant,  . 

JAiMES  MANN,  Hospital  Surgeoh', 


NUMBER  IIL 


I 
1 

i 


dcncral  Hospital,  Malone,  Fcbruaty  4, 18149 

To  Major  General  Brown. 

Respected  Sir — The  regimental  sirgeons  have  neglected 
to  send  with  their  sick  their  bed-sacks.  AH  wc  Can  procure 
here  have  been  already  issued  to  the  sick  in  the  hospitals.  Des- 
titute of  bed-sacks,  the  men  must  suffer  extremely  during  the 
severe  weather.  Information  has  been  received,  that  there  are 
no  sacks  in  the  Quarter  Master  OeneraPs  store.  Blankets  are 
also  wanted.  One  hundred  and  fifty  received  front  Chateauguy 
Four  Corners  have  been  long  since  issued.  Less  than  three 
Mankets  will  not  render  a  man  sick  in  hospital  comfortable. 
With  sentiments  of  high  respect,  I  am, 

your  most  obedient  and  very  humble  servant, 

JAMES  MANN,  Hospital  Surgeon. 
P.  S.    Eighty  sick  have  this  day  been  received,  consequent-' 
ly,  as  many  sacks  and  one  hundred  and  sixty  blankets  are  wvir 

ted  for  these  men.  J.  M«, 

34 


t  i 


U'll 


1 
r 

( 

t  ! 

r  i 

h 

212 


OFFICIAL  LETTERS* 


NUMBER  IV. 


General  UospilaU  Malone,  February  5,  1814. 

To    THE    COMMANCKR    IN    ChIKF. 

Rebpi.ctf.d  Gknkral — During  the  month  of  January,  ac- 
comuioilations  were  provided  Tur  ahout  two  hundred  and  Hft^ 
sick.  This  number  was  received,  and  comrurtably  lodged.  The 
second  of  this  month,  the  A.  I).  Q.  M.  General  at  this  post  vihk 
directed  to  make  additional  provisions  for  the  sick  ordered  here 
from  the  Mills.  A  house  capable  of  receiving  one  hundred 
men  was  procured.  Upon  the  evening  of  the  4th,  two  hundred 
men,  in  addition  to  those  already  in  the  general  hospital,  were 
sent  on.  It  is  impossible  to  render  tlieir  situation  comfortable, 
Avith  the  means  in  our  possession.  Every  house  in  this  vlliagc, 
which  can  be  procured  at  this  time,  is  ap|)ropriated  to  the  use 
of  the  sick.  They  may  possibly  receive  four  hundred.  It  is 
not  possible  to  do  justice  to  these  unfortunate  men,  destitute  of 
bed-sacks,  and  wanting  a(hlitional  blankets.  These  men  were 
sent  on  without  attendants  or  nurses,  without  kettles,  pans,  and 
cups ;  destitute  of  even  an  axe  to  cut  their  own  wood.  These 
evils  are  accumulating ;  while  writing  this,  several  loads  of  sick 
have  arrived  in  a  deplorable  condition.  It  is  now  understood, 
the  sick  of  the  army  are  all  on  their  way  to  this  place.  And  if 
information  be  correct,  and  it  is  presumed  some  opinion  may  be 
formed,  from  returns  already  received,  the  number  ordered  here, 
exceed  one  thousand.  In  what  manner  these  invalids  are 
to  be  covered  from  the  weather  is  not  known.  And  if  secured 
from  the  inclemency  of  the  season,  how  are  they  to  receive 
medical  aid  ?  This  is  not  the  first  time  since  the  war,  the 
hospkal  department  has  been  nooded  with  numbers.  In  the 
mouth  of  July  last,  when  the  general  hospital  was  e»tabliahed 


OFFICIAL  LETTERS. 


2oa 


at  Lewiitown,  on  the  Niagara  frontier,  Ave  hundred  and  forty 
Biclt  were  received  at  on«  time,  from  Fort  Grorge,  when  there 
were  only  three  of  the  ho«|>itu!  detiartinem  present  at  that  post. 
It  viM  impoBsilile  then  to  do  justice  to  the  sick.  There  are  now 
here  more  than  can  be  attended  hy  the  hospital  surj^eons  pres> 
ent.  When  it  is  found  necessary  to  rrmove  all  the  sick  of  tha 
army  to  the  (general  hospital,  (the  hospital  stiitTIteing  too  few  to 
give  lliem  necessary  attendance,)  would  it  not  conduce  to  tho 
benefit  of  (lie  Eiervico,  that  regimental  surgeons  he  directed  to 
perform  hospital  duty  ?  For  while  surgeons  of  hospitals  are  |>er- 
forming  severe  duty,  surgeons  of  regiments  have  little  or  noth- 
ing to  attend  to.  Many  of  the  sick  want  not  only  sacks  and 
blankets,  but  common  clothing.  It  miiy  be  alledged,  these  men 
have  received  nil  their  clothing  due.  Admitting  this  as  a  truth, 
shall  men  be  left  tosufTor?  Cannot  some  measures  be  adopted 
to  remedy  evils  resulting  from  loss  of  their  apparel,  whether 
their  wants  arc  the  consequence  of  unavoidable  casualties,  care- 
lessness, knavery  or  folly  ?  Of  the  means  of  cleansing  euch  ar- 
ticles of  clothing  as  we  have  on  hand,  we  are  destitute ;  not  hav- 
ing a  sufHcient  number  of  men  in  health  to  perform  the  labor  of 
washing.  Women  in  this  part  of  the  country  will  not  do  this 
duty  for  others,  although  they  may  for  themselves.  Humanity 
shudders  at  the  appearance  of  distress,  whatever  may  be  the 
causes. 

Bensible  as  I  am,  that  high  degrees  of  responsibility  are  attach* 
ed  to  my  otlice,  I  am  unwilling  to  suffer  the  evils  above  mea- 
tioned  to  rest  concealed  within  my  own  breast.  To  you  Gen- 
eral, as  Commander  in  Chief  of  tlie  most  respectable,  as  well  as 
important  division  of  the  army  of  the  United  States,  I  am  in  du- 
ty bound  thus  to  state  them;  persuaded  that  nothing  will  be 
wanting  on  your  part,  thst  the  appropriate  temedies  be  admin- 
istered. 

At  present  we  have  at  command  a  supply  of  stores  and  medi- 
cines. With  more  extensive  accommodations,  more  medical 
assistance,  an  additional  number  of  nurses,  more  bedding,  and  a 
shift  of  clothing  to  enable  the  men  to  be  cleaned ;  the  gentlemen, 
of  the  hospital  department  attached  to  mcj  would  be  ambitious 


1 

1    1 

! 

1 
1 
1 

i  .1 


M 


I 


•T^/",^"'      '" 


ze4 


OFFICIAL  LETTERS. 


to  give  a  high  character  to  their  several  ward? ;  and  while  he^ 
stowing  the  balm  of  life  to  the  distressed,  would  acqtrire  addi-< 
tional  honours  and  a  well  deserved  praise.  That  they  poasest 
the  talents  and  disposition  to  execute  (if  they  hud  the  means)  all 
which  may  be  required  of  tliem,  I  have  the  fullest  evidence  to 
believe.  With  the  highest  respect,  &c. 

^  JAMES.  MANN,  Hospital  Surgeon. 


.' 


( 


f! 


.„;!..,  .„  .,!u.7,  i  ,.,,  NUMBER  V; ,.,  .  ,,.,,,...,,^ 


utiy illii  rv  V    t;!  ,  ' 


1  i.i  i-  •■■  ^<th  'i-ij  ;'j-.i  h      General  Hospital,  Feb.  14,  X8I4. 
Extract  of  a  letter  to  Doctor  TiLTcrj,  at  Wilr  'ngton,  Physician 
'  ^  and  Surgeon  General  of  the  Arwi/.    >•■    .  v.- .rn  ■ 

Respected  Sir — Inclosed  you  will  receive  a  proposed  system 
for  the  re-org<\nization  of  the  medical  department  of  the  aimy. 
How  far  ?t  will  meet  with  your  approbation  we  do  not  know. 
With  me  it  is  doubtful  whether  it  will  comport  with  the  views  of 
government,  even  if  it  should  be  approved  by  the  committee  to 
whom  it  is  addressed.  If,  however,  you  should  think  it  worthy 
their  attention,  it  is  our  request  it  may  be  laid  before  them. 

This  is  a  fact,  and  a  serious  one  too,  that  tlie  surgeons  and 
mates  of  regiments,  under  existing  encouragements,  have  no  in- 
ducements to  continue  long  in  service.  Curiosity  alone  will 
induce  them  to  sflcrifice  the  term  of  one  year  in  service.  This 
being  gratified,  its  exciting  powers  lose  their  efifects.  The  pay 
and  emoluments  of  Surgeons  and  mates  of  regiments  do  not  give 
them  a  support,  especially  on  the  frontiers  of  Canada,  where  the 
articles  of  life  are  procured  at  the  most  extravagant  prices. 
With  the  highest  respect,  .^c.  • 

JAMES  MANN,  Hospital  Surgeon. 

REMARK. 

During  this  session  of  Congress,  the  pay  and  emoluments  or 
^e  regimental  SurgQons  were  increased. 


OFFICIAL  LETTERS. 


205 


1.?' 


-vi'-'  i.    ••   1     (1  '-    NUMBER  VL 


General  Hospital,  Burlingtony  April,  1814* 

To  General.  Smith,  Burlington. 

Respected  Sir — There  are  a  number  of  men  in  the  Gen- 
eral Hospital  at  thia  post,  wlio  are  fit  subjects  for  discharge.  It 
is  necesi  ':iry  the  hospital  surgeon  be  possessed  of  their  descrip^ 
five  lists,  to  enable  him  to  make  correct  certificates.  The  regu- 
lations of  the  General  Hospitals  are,  that  every  man  admitted  be 
furnished  with  his  description  roll  upon  his  admittance ;  these 
are  put  on  file,  to  be  used  if  necessary.  In  many  instances,  these 
rolls  have  not  been  forwarded ;  in  some,  refused  by  officers  of 
companies.  To  remedy  the  evils  arising  from  these  irregulari- 
ties, the  interference  of  the  commanding  general  is  necessary. 
With  high  respect,  &;c. 

JAMES  MANN,  Hospital  Surgeon, 


I 


'? 


!  i! 


NUMBER  VIL 


,       General  Hospital,  Burlington,  April  21,  1814. 

To  Colonel  Smith,  29th  Regiment,  at  Plattsburgh. 

Sir — Inclosed  you  w.  \  receive  the  written  orders  directed  to 
two  men  of  your  regiment  in  ray  hospital,  to  join  their  regiment 
immediately,  or  be  considered  as  deserters  and  treated  as  such. 
No  man  regularly  admitted  into  the  general  hospital  can  be  con- 
sidered as  a  deserter  while  in  the  hos|)ital.  No  officer  has  au- 
thority to  order  a  map    'ui  of  the  general  hospital,  until  he  is  re- 


I  \,i 


( 


l\' 


If  Pi,-' 


u 


26^1 


•PPICIAL  LETTERS. 


ported  fit  for  duty,  or  by  an  explicit  order  from  the  Commanding 
General.  In  either  case,  it  is  expected  that  so  much  respect,  at 
least,  be  shewn  to  the  hospital  department,  the  application  Tor 
discharge  from  the  hospital  be  made  to  the  senior  surgeon  pres- 
ent, not  directly  to  the  man  himself.  This  last  procedure  is 
calculated  to  induce  irregularities  in  the  hospital.  Men  must 
not  leave  the  hospital  without  the  knowlc  Ige  of  its  otficera. 
Evils  too  much  abound  in  our  department,  without  measures  to 
create  more.  In  addition,  I  have  to  state,  lh;it  general  orders 
were  in  force,  which  prohibited  men  from  joining  tlieir  regiments 
at  PInttsburgh,  even  if  capable  of  duty.     The  men  demanded  by 

liieutenant  H were,  however,  not  fit  for  duty. 

I  am,  with  much  respect,  &c.  •     > 

JAMES  MANN,  Hospital  Surgeon.  ' 


NUMBER  Vlll. 


M 


it'  ■ 


if 


General  Hosjjital,  Burlington,  April  28,  18l4» 

To  Brigadier  GENEiiAii  Smith. 

Sir — It  16  with  pain,  I  am  obliged  to  state  to  you,  that  three 

men  of regiment,  have  since  the  23th  instant^  found  their 

way,  or  been  brought  into  the  general  hospital  in  an  irregular 
manner.  It  has  been  reported,  these  men  have  had  no  medi- 
cal aid,  previous  to  admittance.  Had  it  not  been  for  tb  call  of 
humanity,  they  would  not  have  been  so  received ;  but  their  con- 
dition was  deplorable.  One,  brought  last  evening  in  a  dying 
fltate,  lived  a  few  hours  only.  The  sick  are  not  so  numerous, 
at  this  time,  but  that  ihey  may  be  faithfully  attended  by  the  sur- 
geons of  regiments.  If  the  last  man  had  been  seasonably  re- 
portetl,  Jiis  life  might  have  been  spared.  The  last  part  was  the 
duty  of  the  surgeon  to  attend  to ;  and  where  there  is  no  surgeon, 
it  becomes  the  duty  of  the  immediate  commanding  officer  of 
company.    Of  what  ise  can  it  be  to  send  a  dying  man  to  the 

/ 


ii'liii 


OFFICIAL  LETTERS. 


t267 


bMpital,  except  to  give  the  hospital  department  the  credit  cX 
kilUr^,  and  trouble  of  burying  him !  U  men  are  aent,  in  caaeg 
where  they  cannot  be  attended  or  cured  by  their  own  regimen- 
tal Burgeon,  it  is  desirable  to  have  them  reported  before  they 
are  in  a  moribund  state. 

Very  respectfully,  &c. 

JAMES  MANN,  Hosyitcl  Surgcotii 


i 


NUMBER  IX. 


General  Hospital^  Pittsburgh,  August  17,  1814. 
To  Colonel  Cummi!n8,  Adjutant  General. 

SiR-^There  are  in  the  general  hospital  at  this  cantonment, 
more  than  one  hundred  men,  who  require  medical  aid.  These 
are  under  my  sole  care.  In  addition.  Doctor  Whbaton  takes 
charge  *"  the  hospital  in  the  village,  in  which  are  thirty  pa- 
tients. The  several  surgeons  in  this  cantonment  have  eftch  ia 
their  respective  bos[)ital3  from  fifty  to  ninety  sick.  Doctor 
Wheaton  and  myself  are  the  only  surgeons  of  the  hospital  de- 
partment present,  capable  of  duly;  hospital  surgeon's  mate  Pur- 
cell  being  confined  with  an  intermittent  fever.  In  addition  to 
my  duty  of  prescribing,  of  making  up  my  prescriptions,  attend- 
ing to  the  police  of  the  hospitals,  I  have  yet  to  provide  for  the 
accommodation  of  one  hundred  more  recently  sent  up  from  th& 
lines  of  the  army  at  Chazy,  without  any  ho8i)ital  assistants ; 
having  no  Steward,  no  Ward-Master,  no  Orderly,  capable  of 
making  out  provision  returns,  (Steward  and  Ward-Master  being 
sick)  nor  even  an  attendant  capable  of  preparing  the  diet  in  a 
suitable  manner. 

This  statement  however,  is  not  made  with  a  view  to  censurdr 
any  officer ;  but  that  you  will  order  hospital  surgeon's  mate  Rus- 
ai^LL,  who  has  lately  reported  himself  at  your  office,  to  perform 
duty  at  this  po^t.    I  have  no  doubt  the  Commander  in  Chief,  in 


'■    » 


if  i* 


fi 


NW 


m^^'J. 


TTTT?" 


26ft 


OFFICIAL  LETTERS* 


all  his  transactionf ,  will  consult  the  good  of  tbe  service ;  yd 
duty  compels  me  to  state,  that  with  every  exertion,  full  justice 
cannot  be  done  the  sick. 

Very  re!»r  'ctfully,  . 

JAMES  MANN,  Hospital  Surgem. 

• '  \'    • 

NOTE. 

On  the  Ist  September  following,  the  hospital  returns  counted^ 
more  than  seven  hundred,  with  one  assistant  only. 


1 

NUMBER  X. 


■Extract  of  a  Letter  addressed  to  Doctor  Tilton,  Surgeon  General 
of  the  Army,  dated  Plattsburgh,  Hospital  DepartmeiUy  Septem- 
ber 2,  1814. 

Respected  Sir — You  will  atone  view  perceive  this  division 
of  the  army,  is  not  sufficiently  furnished  with  medical  aid.  I 
have  only  one  assistant,  on  whom  much  dependence  can  be 
placed,  this  is  surgeon's  mate  Russell  ;  Purcell  is  out  of 
health. 

General  Izard,  when  he  left  this  post  with  his  army,  ordered 
with  his  division,  hospital  surgeons  Hayes  and  Brunough  ; 
and  mates  Wallace  and  Walker.  The  sick  of  the  division, 
were  placed  under  my  charge.  Hospital  surgeon  Wheaton, 
had  previously  obtained  leave  of  absence,  on  account  of  bad 
health.  Hospital  surgeon  Hunt  is  at  Burlington,  with  Tre- 
VETT,  as  his  assistant.  You  will  perceive  there  is  placed  on 
me,  more  duty  <han  it  is  possible  for  me  to  perform. 

Se;;tember  3. 

The  sick  and  convalescents  have  been  ordered  to  Burlington 
Vermont ;  but  for  want  of  transportation,  are  removing  to  Crabb 
Island,  two  miles  ^nd  a  half  from  the  fortifications  at  Plattsburgh. 


OFFICIAL  LETTERS.  «f59 

Such  of  the  convniesceiits  ag  can  perform  garr'iBon  duty  are  or- 
dert^d  into  the  forts.  More  than  tive  hundred  have  already  ar- 
rived at  Crabb  Island,  a  barren  uninhabited  spot.  Hospital 
tents  to  cover  them  have  been  furnished.  Doctor  Purcell,  ia 
now  my  only  assistant,  and  he  sick.  Russell  is  ordered  into 
one  of  the  forts.  Doctor  Low,  assistant  to  the  Apothecary 'Gen- 
eral, has  volunteered  hi«  services,  and  is  also  attached  to  one  of 
the  forts. 

CraJjh  Island,  Septembtr  10; 

We  have  received  the  wounded  of  the  army,  about  forty. 
Pour  hundred,  with  the  assistance  of  Commodore  Macdonouch, 
have  been  sent  to  Burlington  hospital  from  this  place.  I  am 
left  destitute  of  any  assistant ;  except  the  services  of  Doctor 
Brown,  and  two  medical  students,  who  have  volunteered  them- 
aelves,  my  situation  would  be  most  unpleasant  and  distressing. 
Respectfully  your  humble  servant, 

JAMES  MANN,  Hospital  Surgeon. 

NOTE. 

On  the  morning  of  the  11th  of  September,  the  remainder  of 
the  sick  were  all  sent  to  Burlington. 


. 


■| 


NUMBER  Xr. 


Plattsburgh,  November,  1^14, 

Extract  of  a  communication  to  Doctor  Tilt6n,  Physician  and 

Surgeon  General  of  the  Army. 

Respected  Sir — If  we  may  be  allowed  to  draw  conclusions 
from  the  present  aspect  of  our  political  affairs,  the  prosp*"ct  of 
peace  ia  remote ;  while,  should  the  war  be  ooatinued,  to  me  it 
35 


I    : 


1 

■     : 

1 

■i 

^■7* 


OFFICIAL  LETTERS. 


leems  highly  importHiit,  the  medical  stafTof  the  army  be  placed 
on  n  more  respectable  basts,  than  its  present  establishment.  To 
ju(lu;e  of  the  conduct  of  sume  officers  of  the  line,  towards  the  med- 
ical staff,  particularly  that  branch  attached  to  hospitals,  it  ap- 
pears they  are  considered  in  no  higher  light  than  ivarrant  offi- 
cers. It  is  well  understood,  the  medical  staff  have  no  command 
out  of  the  hospitals,  indeed  they  ask  for  none  ;  they  wish  only 
to  be  respected  in  their  own  department.  There  is  nothing  in 
the  rules  and  regulations  of  the  army,  to  deter  commissioned 
officers  of  the  lowest  grade,  from  intruding  within  hospital 
bounds,  and  assuming  authority  to  order  their  men  in  and  out'of 
it  ad  libitum.  Intrusions  of  this  nature  too  frequently  occur,  to 
pass  without  notice ;  but  when  they  have  been  reported  to  the 
commanding  general,  redress  has  been  obtained  by  a  special  or- 
der in  the  case.  I'his  does  not  place  the  hospital  department 
beyond  the  reach  of  vexatious  interferences. 

In  all  services,  except  our  own,  the  medical  staff  of  the  army 
is  respected,  because  it  is  protected  by  government.  Even  where 
it  is  clothed  with  any  powers,  it  is  not  placed  in  an  attitude  to 
exercise  them.     The  senior  surgeon  of  the  army  is,  ex  officio, 
constituted  director  of  hospitals,  and  is  made  superintendant  of 
their  building.     At  the  close  of  this  campaign,  orders  were  is- 
sued to  erect  hospitals  for  the  sick,  in  which  the  director  was 
not   known  ;    and  although  the   rules  and   regulations   of  the 
army  designate,  the  sick  of  the  army  be  the  firsi  accommodated, 
yet  the  present  season,  they  are  the  last.     The  regiments  have 
their  barracks  nearly   completed,  as  have   also  the  artificers; 
■while  the  foundations  of  the  hospitals  are  but  just  commenced. 
The  sick  consequently  are  in  tents,  and  will  remain  in  them 
nntil  the  cold  becomes  severe.    The  sick  with  typhus,  can  hard- 
ly recover  at  this  season,  exjiosed  as  they  are  to  cold  and  mois- 
ture.    Medicine,  under  such  circumstances,  can  have  but  little 
good  effect.     If  men  die,  the  skill  and  assiduity  of  the  surgeon 
are  called  in  question,  without  considering  the  real  fatal  causes ; 
while  it  is  frequently  the  case,  the  most  judicious  are  censured, 
and  accumulated  disgrace  unjustly  attached  to  them»^ 


I  i 


OFFICIAL  LETTERS. 


27 1 


t  In  events  of  high  impartance,  it  is  seltlom  the  medical  staff 
are  noticed.  This  is  discouraging  to  the  ambitious  young  surgeon 
of  the  army.  It  oiay  be  alleged,  the  surgeons  being  non-com> 
batants  are  out  of  danger.  This  however  is  not  always  the  case. 
During  the  investment  of  Plattsburgh  by  the  enemy,  the  sur- 
geons were  constantly  passing  from  fort  to  fort,  or  block-houses, 
to  dress  the  wounded,  exposed  to  a  cross  fire  of  round  an<l  grape 
shot ;  while  the  greater  part  of  the  army  were  covered  by  forti- 
ficatioBs.  The  cool  bravery  of  the  surgeons  were,  in  private 
conversation,  noticed  by  the  Commander  in  Chief;  had  half  as 
much  been  reported  to  the  War  Department  respecting  them, 
they  would  have  felt  themselves  amply  compensated.  While 
making  this  observation,  I  do  not  include  myself;  because  I 
was  snug  on  duty  at  Crabb  Island,  out  of  mueh  danger,  while  our 
fleet  continued  master  of  the  lake.  If  reports,  honorable  to  offi- 
cers, are  founded  upon  good  conduct  and  cool  bravery,  who, 
more  deserving  than  the  non-combatants  ?  They  have  few- 
er motives  to  excite  tltem,  and  are  equally  ex|)08ed  to  danger 
as  officers  of  the  line,  whose  minds  as  well  as  bodies,  are  con- 
stantly exercised  by  their  commands.  If  any  officer  has  hard- 
ships attached  to  his  office,  it  i3  the  surgeon  who  executes  his 
duty  with  fidelity  and  assiduity. 

I  feel  myself  bound  to  report  with  much  respect,  the  conduct 
of  all  the  medical  gentlemen  attached  to  this  army,  who  have  at 
all  times  this  campaign,  performed  their  duly ;  and  who,  for 
their  particular  services,  during,  and  after  the  investment  of 
Plattsburgh  by  the  enemy,  merit  lh«  applauses  of  their  country. 

To  discriminate,  would  be  an  act  of  injustice.  Doctors  Law- 
son  and  Mason,  surgeons  of  regiments,  Warmsley,  Beaumont 
and  Hugo,  surgeons  mates,  have  all  deserved  well  of  their  gov- 
ernment. I  would  particularly  mention  Russell,  hospital  sur- 
geons mate,  and  Low,  Assistant  Apothecary  General,  who  vol- 
unteered his  services,  for  their  attention  and  professional  abili- 
itiea,  at  a  time,  when  the  wounded  of  both  fleets  and  army  were 
placed  under  ray  charge;  on  whom  were  performp<l,  immediate- 
ly after  the  action,  more  thao  thirty  capital  oi)eration»r     It  i* 


':■: 


■'1   . 


)  : 


1*1]  f 


:P 


"  -<"W^n   ■t-.jrr^T^,-.^-. 


272 


OFFICIAL  LETTERS. 


with  mucli  pride,  this  opportunity  is  improved  to  state,  that  Ihe 
medical  gentlemen  of  our  army  and  navy,  were  not  inferior,  Init 
superior  to  the  medical  gentlemen  of  the  British  navy  ;  several 
of  whom  were  made  prisoners  of  war,  and  assisted  lo  tlress  the 
wounded  of  their  own  fleet.  This  circumstance  is  very  fliifler- 
ing  to  our  infant  medical  institutions;  and  is  c;ood  evidence, 
tliey  are  not  less  respectable  than  the  anciunt  schools  of  Europe. 
'     With  the  highest  respect,  &c. 

JAMEB  MANN,  Hospital  Sttrgcoiu 


m\\ 


NUMBER  XII. 


General  Hospital,  Plaltsburgh,  Novemher  6,  181 4. 
To  Elbridge  Gerry,  Vice  President. 
Honorable  Sir — Permit  me  to  intrude  upon  you,  while  em- 
ployed in  the  highest  concerns  of  the  nation,  and  invite  your  at- 
tention to  a  subject,  which  by  me  is  considered  of  no  small  im- 
portance— no  less  than  a  more  comfortable  provision  for  such 
soldiers,  as  have  become  decrepid  in  the  service  of  their  coun- 
try. There  are  many  of  this  descrijition  rendered  unable  to 
jirovide  by  manual  labour  a  subsistence ;  broken  down  by  se- 
vere duty  and  hardships,  during  unfortunate  and  unseasonable 
campaigns.  Many  of  this  description,  at  this  time,  are  strolling 
about  the  country,  subsisting  upon  the  charity  of  individuals  to 
the  no  little  disgrace  of  the  nation.  Orders  have  been  issued  this 
autumn,  to  discharge  from  service  all  incapable  of  bearing  arms 
in  the  field  ;  many  of  these  have  not  been  mustered  for  months, 
having  been  absent  from  their  cor[)s  in  hospitals;  and  who,  con- 
sequently, have  not  received  pay  during  these  periods.  A  large 
proportion  of  these  men  have  not  the  necessary  documents  fur- 
nished by  officers,  to  enable  them  to  receive  their  pay  justly 
due.     To  cast  these  disabled  men  upon  the  wide  world,  will 


OFFICIAL  LETTERS. 


273 


plnce  them  in  a  distresBcd  situation  ;  in  which,  hereafter,  they 
will  not  be  aide  to  exhibit,  and  prove  their  demmds  ujion  gov- 
ernment; and  being  thus  liberated  from  their  connection  with 
the  army,  will,  by  their  complaints  and  unlavoralde  reprt'SJinla- 
tioijs,  render  the  service  unpopular,  and  discouriige  the  recruit- 
ing of  our  armies.  Men  already  ilischarged,  under  the  above 
circumstances,  have,  I  am  persuaded,  injured  the  reuruiliug 
•ervice. 

Some  of  these  invalids  hare  incumbered  our  hospitals,  a  year 
and  more,  for  want  of  necessary  documents,  by  which  they  may 
be  honorably  discharged.  Officers  last  winter  were  called  upon 
to  furnish  the  necessary  papers;  but  these  are  witlilield  l)y 
them,  it  is  presumed,  from  sinister  views,  at  a  time  the  regimenis 
were  about  to  be  consolidated.  Hence  it  is,  while  the  rolls  of 
the  army  at  the  war  department,  appear  strong  as  to  numbers, 
they  are,  com|)arativel3%  weak  as  to  efficient  force. 

Many  invalids,  although  incapable  of  field  duty,  may  be  ser- 
viceable in  garrisons,  where  they  are  able  to  defend  the  lines  of 
fortifications.  These  men  also,  may  be  employed  in  fixing  am- 
munition ;  some  may  be  employed  as  artiticcrs. 

If  it  would  not  be  considered  that  I  assume  too  much,  a  sug- 
gestion is  made  to  government,  to  place  these  men  in  a  comfoit- 
able  situation,  in  which  they  may  be  made  useful  to  the  nation, 
instead  of  travelling  through  the  country  as  vagfants.  Many, 
when  discharged,  return  to  the  bosom  of  their  families ;  but  it 
should  be  known,  that  many  of  these  decrepid  men  are  foreign- 
ers, having  no  homes,  and  must  depend  on  charity  for  su!)sigt- 
ence.  Oder  them  a  home,  especially  such  as  may  accept  it. 
Let  a  corps  of  invalids  be  established.  This  corps  should  be 
considered  honorable,  as  being  com|)osed  of  veterans,  disabled 
in  service.  *It  should  be  considered  as  the  most  honorable  mili- 
tary institution  in  the  nation  ;  where  not  only  the  war  worn  sol- 
dier, but  the  rfiecrfpirf  officer  may  find  an  asylum,  in  which  he 
may  enjoy  the  comforts  of  life,  with  a  heart  overflowing  with 
gratitude ;  that  his  government  duly  estimates  his  valour  and 
patriotism,  and  here  receive  a  just  but  inadequate  recompense 


I 


vi  i 


l' 


-'         1 

I'ii  i 

i: 
"i' 

274 


OFFICIAL  LETTEKS. 


for  thfl  toils  he  endured,  the  dangers  he  encountered,  and  the 
vrounds  he  received  in  the  service  of  his  country. 
With  the  hi|;he8t  respect,  I  am 

your  most  obedient  and  very  humble  servant, 

JAMES  MANN,  Hospital  Surgeon,. 

To  this  communication,  a  reply  was  received,  Bif;ned  by  th« 
Hononrabio  Mr.  Gbrry,  the  day  previous  to  his  death. 


?A  ^./,..' 


5'*(» 


*  .'  t  ' 


4  ':' 


APPENDIX. 


» • 


." 


A  DISSERTATION  ON  DYSENTERY, 
>rHICH  OBTAINBD  THE  BOYLSTON  PRIZE  MEDAL  FOR 

1800. 


. 


To  Ward  Nicholas  BoylstoNj  Esf. 


>IR, 


The  first  honours  of  your  benevolent  institution  for  the  pf«V 
motion  of  medicine,  and  the  sciences  connected  with  the  healino- 
art,  were  conferred  in  1803.  The  fortunate  dissertation  on 
Cholera  Infantum  was  impressed  with  a  token  of  your  appro^- 
bation,  l)y  permitting  its  author  to  dedicate  it  to  yourself.  This 
dissertation  on  dysentery  is  so  intimately  connected  with  the 
former,  that  the  author  was  induced  to  become  a  competitor  for 
the  prize,  which  was  a(\judged  him  in  1806.  Various  circura* 
stances  have  conspired  to  prevent  its  publication  until  noww 
Among  the  most  potent  was,  that  in  reviewing  the  dissertation, 
it  was  found  to  embrace  no  new  principle  in  theory,  nor  im- 
provement in  practice.  A  determination  was  adopted,  not  to 
expose  it  to  the  eye  of  the  world.  But,  since  the  adjudication 
was  publicly  announced,  repeated  applications  have  bsen  made 
by  friends  for  a  copy,  excited  probably  more  by  curiosity  thaa 
an  expectation  of  acquiring  any  new  ideas  on  the  subject.  Ta 
gratify  a  curiosity  thus  excited  is  one  reason  now  offered,  why 
the  author  assents  to  its  appearance  in  print.    If  the  dissertation 


'    1 


I'. 


'  .'n^'Mjiiui 


;^^) 


IjI 


jf^r-^fr^.fffmfi*j,*>»9.rj  *>,  |ii^J?p^w*  i^M  I  ■•■rj,  ,.!*«, 


■^^U  '■  ',,'Jl«JWt«  WT"Jff 


IMAGE  EVALUATION 
TEST  TARGET  (MT-3) 


1.0 


I.I 


1.25 


rM  121 


2,2 


miuu 

^  IIIIII& 


^ 


7. 


V 


7^ 


y^ 


Photographic 

Sciences 
Corporation 


^' 


m 


!\ 


V 


[v 


^ 


^ 


;\ 


23  WEST  MAIN  STREET 

WEBSTER,  N.Y.  14580 

(716)  873-4503 


7^^ 


27(J 


APPENDIX. 


i.    i 


has  any  claims  to  merit,  it  will  appear  as  comprising  in  a  com' 
pciuUous  form,  the  most  approved  practice  in  the  United  States. 
Diseases  of  the  bowels  are  among  the  most  formidable  disor- 
ders to  which  armies  in  the  tented  field  are  exposed  ;  produced 
by  hardships,  bad  provisions,  insalubrious  climates  and  unhealthy 
positions.  As  these,  on  the  northern  frontiers,  appeared  under 
forms  different  from  those  in  domestic  practice  ;  the  additional 
observations  respecting  the  disease  among  soldiers  will, not  be 
unacceptable.  In  proportion  as  the  usefulness  of  this  disserta- 
tion is  more  enlarged,  so  the  object  of  your  benevolence  is  pro- 
moted. Your  views,  similar  to  your  good  and  great  prototype, 
the  immortal  Howard,  are  not  circumscribed  within  narrow 
limits ;  they  embrace  not  only  states  and  kingdoms,  but  the 
whole  human  race. 

No  further  apology  is  believed  necessary,  for  the  publication 
of  this  dissertation,  connected  with  the  diseases  of  the  army. 

The  author  deprecates  wars,  as  well  as  the  causes  which  ex- 
cite nations  to  arms  against  each  other.  From  a  state  of  barbar- 
ism, by  the  instrumentality  of  a  few,  the  horrors  of  a  field  of 
battle  have  been  progressively  ameliorated ;  penal  laws  are 
rendered  less  severe,  and  our  prisons  converted  to  comforta- 
ble asylums  for  the  wietched ;  wherein  penitentiary  hours  for 
reflection  and  reformation  are  granted  ;  and  while  under  the  sal- 
utary discipline  of  retributive  justice  for  evils  inflicted  on  socie- 
ty, criminals  may,  by  solitary  labour,  make  a  partial  atonement  for 
their  sins.  These  improvements  are  the  glorious  and  happy  ef- 
fects of  that  spirit  of  divine  love,  imbibed  from  the  doctrines  of 
Christianity.  These  doctrines,  in  proportion  to  their  diffusion, 
have,  in  some  degree,  softened  the  calamities  of  war,  and  avert- 
ed its  attendant  evils. 

While  philanthropy  invites  to  her  aid  the  benign  arts  and  sci- 
ences, which  improve  the  state  of  society,  and  meliorate  the  con- 
dition of  man ;  she  causes  to  be  inscribed  upon  the  historic 
page — a  monument  morq  durable  than  marble  or  brass^ — the 
names  of  those  philanthropists,  the  worthies  of  every  age  and 
country,  who  have  devoted  their  lives,  fortunes,  or  time  to  her 
cause. 


ArPENDIX. 


«T7 


ITnrvard  University  with  pride  enrols  (he  name  of  Botl3ton 
am  .  .;  her  m  «st  lilieral  benof  ictors.  The  medical  college  of 
ili.it  iMiu'«>r8ity  will  lons^  remember  him  among  its  principal  pat- 
rons; vvlMJe  the  rapid  improvements  in  the  healing  art  in  New- 
H  ;<:,!  md  Dear  testimony,  that  to  his  munificence  they  are  highly 
iniieited,  lor  their  increasing  extension  and  wide  diffusion. 

May  he  long  survive  his  establishment,  to  enjoy  the  sublime 
snt  sfiict'on  of  witnessing  the  multi|>lied  benefits  resulting  from 
liis?  rility,  is  the  sincere  wish  of  his  most  obedient,  and  very 
huinjie  servant,  THE  AUTHOR. 


ADJUDICATION. 

It  a  mMing  of  the  C&mmiUecupon  the  Boi/lston  prise  question  (as 
pnOliihed  the  ]3th  March  last)  at  Boston,  December  31  *f,  180&. 

PiiESENT,  ISA  \C  RAND,  M.  D. 

LEMUEL  HA YWARD,  M.  D. 
JOHN  BROOKS,  M.  D. 
BENJ.  WATERHOUSE,  M.  D. 
AARON  DEXTER,  M.  D. 
JOSIAU  BARTLETT,  M.  D. 
WILLIAM  SPOONER,  M.  D. 

*  A  dissertation  on  the  first  question,  relati\  -  (o  mortification, 
and  one  on  the  seccnd  question,  relative  to  dysentery,  having 
been  read  and  duly  considered,  the  question  was  taken  whether 
Ihey  were  resj)ectively  entitled  to  the  premiums  offered,  and  it 
■was  determined  in  the  affirmative,  on  condition,  that  neither  of 
them  should  be  published,  unless  revised  aitd  abridged  by  the 
authors. 

"  On  opening  the  papers  accompanying  the  dissertation,  it  ap- 
peared  that  the  one  on  mortitication  was  written  by  George 
Cheene  Shaituck  of  Templeton,  in  the  county  of  Worcester; 
»-d  the  other  on  dysentery,  by  James  Mak«  of  Wrentham,  m 
ttie  county  of  I^orfolk. 

30 


■:   I 


I    (■ 


m- 


:l\ 


It 


')!Mm^  »v«iMM«a«a««t<~  - 


y^ 


27a 


APPENDIX, 


"  Votett,  That  the  chairmun  be  requested  to  write  to  Doclof 
SuATTccK  and  Doctor  MA^N,  and  also  to  the  President  of  Har- 
vard College,  inrorming  them  respectively  of  the  doings  of  the 
Committee,  and  (h>tt  the  adjudication  be  published  ia  the  Ce> 
lumbiun  Centinel,  aud  Independent  Chronicle." 


|i 


ADVERTISEMENT. 

AeRCGABLY  to  the  recommendations  of  the  adjudicating  cora* 
mittev,  the  following  dissertation  has  been  revised  and  abridged. 

No  alterations  have  been  made  in  respect  to  the  causes  and 
the  general  treatment  of  the  disease,  excepting  some  ot)8erva- 
tions  have  been  added,  which  were  made  on  the  northern  front- 
iers, on  the  disease  as  it  appeared  in  the  army. 

In  conse(j»ence  of  an  objection  adduced  to  the  author's  hy- 
pothesis, that  materials  under  the  form  of  gass  are  one  cause  of 
dysentery,  the  consideration  of  that  subject  is  more  fully  attend- 
ed to,  aud  for  the  sake  of  elucidation,  some  observations  are  ad" 
ded. 

It  has  been  urged,  the  author  empleys  inefficient  cathartics. 
This  objection  will  be  removed,  when  the  reader  understands, 
that  liberal  evacuations  frotn  the  intestinal  tube  are  strenuously 
enjoined  in  all  cases  of  dysentery.  Will  it  be  a  question,  by 
what  kind  of  cathartic  medicine  this  is  efTected,  if  the  intention 
is  fully  accomplished  ?  May  not  the  less  irritating  cathartics,  in 
large  doses,  fulfil  the  intention,  as  well  as  the  more  drastic,  with 
less  hazard  of  an  hypercatharsis  ?  During  the  last  war  there 
•were  experienced  a  few  cases  only,  compared  with  the  num- 
ber attacked,  which  required  very  active  medicine.  Drastic 
purges  are  sometimes  retjuired  for  patients  of  robust  bab'its.  The 
practice  in  this  dissertation  is  applicable  to  dysentery  as  it  ap- 
pears under  every  circvmstance  of  age,  habit,  temperament,  and 
climate. 


rr — 3 


A  DISSERTATION 

tJPON  THE  CAUSES  OF  THE  VARIETIES  OBSERVED  IN  DYS* 

ENTERY,  AND  THE  METHODS  OF  TREATMENT  ADAP- 

TED  TO  THE  CURE  OF  THESE  VARIETJES. 


PATHOGNOMONIC    OBSERVATIONS. 

It  may  not  be  improper  to  observe,  that  the  appellation,  dys- 
•Dtery,  is  derive*:!  from  the  Greek  Unvunge,  denoting  a  bad  state 
of  the  intestines.  Hippocrates,  the  father  of  medicine,  gives  the 
following  definition  :  "  When  the  body  is  heated  and  there  are 
acrimonious  purgings,  with  bloody  stools,  corrosion  and  ulcera- 
tion of  the  intestines,  the  disease  is  called  dysentery."  His  co- 
temporaries  and  more  immediate  sitccessore  adopted  an  opinion 
that  ulceration  and  corrosion  were  necessarily  connected  with 
the  other  symptoms ;  but  physicians  of  the  present  age  consider 
these  morbid  affections  within  the  intestines  the  consequence  of 
the  disease,  not  the  immediate  cause  of  the  symptoms  constitu- 
ting the  several  phenomena. 

The  various  nosological  descriptions  of  dysentery,  as  being 
little  applicable  to  practice,  we  decline  to  notice;  but  shall  pro- 
ceed to  point  out  its  most  prominent  symptoms,  as  described  by 
physicians  of  the  present  day. 

Dysentery  should  be  distinguished  from  diarrhoea  and  other 
diseases  of  the  same  organs;  which,  aithi>u<i;h  they  m^iy  change 
from  one  to  the  other,  require  in  several  respects  very  dissimilar 
methods  of  treatment. 

In  dysentery  the  evacuations  are  small,  accompanied  with 
gripes  and  tenesmus}  eviacing  that  there  is  some  obstacle  to  the 


i    t 
I    1 


_i.j*" 


7 


.260 


APPENDIX. 


free  dlacharge  of  fecal  niateriala  lodged  in  llie  intrfilinal  mm}. 
In  diarrhrcH  the  flux  is  (opiuus  without  lencgnitis,  »<triM-tinitB  'in- 
voluntary ;  wherefore  gript'S  iind  teiirsinsis  nrf  vonsitli  ti  d  the 
pathognomonic  B)'tnj>tom3  of  dyseiitrry.  In  Ihr  liifti  onset  ol  <he 
diflOiiae,  tiip  tcnt'smiis  which  accompanicB  the  <i>inidaiiit  ;b  .-  »- 
gravated  hy  fecal  congestions;  l)ut  it  is  c^rl;un  Ihui  lh«-  Un.^s- 
mus  which  exists  after  the  disease  is  of  some  <ii;r  itloii,  is  not 
0  consequence  of  congestions,  hut  increaseil  seiis.lMlity  Hnd  irri- 
tnhility  of  the  villous  coats  of  the  rectum,  the  ell'ccl  of  iiiiiaiutua- 
iion  and  ulceration.* 

In  its  progroBS  through  its  several  stages  the  disease  appears 
often  under  various  forma,  generally  iisliered  in  willi  slight  rig- 
ors, accelerated  pulse  not  full,  witij  sliiriU  pain  in  the  head  and 
back ;  after  some  hours  iiicre  'aed  heat  and  soreness  upon  pres- 
sing the  al)domen.  The  ('.iscase  is  sometimes  iiccom|)anied  with 
coldness  of  the  extremities,  small  pulse,  diminished  heat,  nausea 
imd  vomiting,  even  at  its  first  attack.  The  last  form  takes 
place  mostly  on  persons  advanced  in  years;  in  cases  also,  where 
the  patient  had  been  previously  exhausted  of  the  vital  princijtie 
by  cold  fatigue  and  lind  provisions.  This  combination  of  canses 
Among  the  soldiers  was  productive  of  a  most  formidalde  disease. 

The  most  common  evacuation  in  the  disease  is  mucus  streak- 
ed with  blood.  The  immediate  cause  of  this  appearance  is  in- 
-flammntion ;  the  sensibility  of  the  coats  of  the  intestines  is  in- 
creased, while  the  muciis  designed  by  nature  to  defend  them  from 
injury  is  voided  by  violei^t  etforts,  and  the  more  substantial  feces 
retained  by  spasm,  or  stricture.  This  form  constitutes  the  ide-. 
opathic  dysentery .-f  i    v  -       ■..  ./     . 

When  the  disease  is  not  cured  in  its  early  stages,  a  bloody 

*  It  was  the  case  that  when  tenesmus  succeeded  profuse  diarrhoea,  as  it  ap- 
peared among  the  soldiers  on  the  northern  frontiers,  that  states  of  ulcera- 
tion and  inflammation  were  demonstrated  by  many  dissections  of  those  who 
died  by  the  disease. 

t  The  tenesnial  diarrhoea,  wliich  destroyed  many  during  the  war,  in  most 
oases  succeeded  simple  diarrhcua,  the  consequence  of  continued  exposure  to 
the  primary  causes  of  the  last  complaint,  and  required  a  treatment  very  opj» 
^osite  io  tbe  ideopathic  form. 


k 


It 


■.i.. 


APPENDIX. 


€8i 


•antes,  ar  mittertala  not  <lis8imilar  to  the  drei^s  of  red  wine  are 
ilejerted.  These  (I'lBcharges  demonstrate  a  mori)id  jecretion  of 
the  infl.imed  sfirfuce  of  the  inner  coat  of  the  intestines,  and  defw 
eictit  venous  ahsorption. 

In  the  last  stige  of  the  dieease,  especially  wliere  it  has  con* 
tinued  a  joiie;  time,  part  of  the  di8char|;e8  are  not  unlike  cheese 
curds,  similar  to  the  apthous  incrustations  often  observed  on  the 
tonu;(ie,  and  which  line  the  throat,  stomach  and  intestines 
throughout  to  the  rectum  ;  i..nd  when  they  are  separated  from  the 
little  ulcerations  to  which  Ihey  are  atiixed,  are  evacuated  with 
other  fecal  m  iterials.f  These  apthoB  are  formed  from  the  coag- 
ulahle  lym  ih,  and  hive  (irobahly  for  their  cause,  says  Dvawrx, 
an  increiisi'il  action  of  the  seceruing  system  from  increased  sen- 
gatiun,  with  a  decreased  action  of  the  absorbent  system  from  de- 
creased irritation. 

Balls  of  ind'Tated  feceii,  called  by  medical  writers  sci/bala,  are 
sometimes  ev  icuated.  The  fecal  materials  retained  within  the 
fohlings  of  the  intestines  are  moulded  into  balls,  which  having 
their  more  fluid  parts  absorbed  or  evacuated  l)ecome  hard,  and 
by  irritating  the  extremely  sensible  coals  of  the  intestines,  ag< 
gravate  the  gripes  and  tenesmus.  It  has  been  ol»served  by 
medical  authors,  that  when  these  congested  feces  have  been 
evacuated,  that  the  patient  has  been  relieved  from  the  torturing 
pains  and  tenesmus,,  which  have  induced  a  belief  that  they  were 
the  cause  of  the  disease,  which  has  frequently  induced  a  coulii)- 
nation  of  purges  to  the  no  small  aggravation  of  all  the  violent 
symptoms,  whi^h  they  were  intended  to  oiiviate.* 

The  villous  coats  of  the  intestines,  in  consequence  of  exces- 
sive inflammation,  are  detached  from  their  contiguous  parts  after 
a  similar  manner  the  cuticula,  in  cases  of  sphacelus,  is  from  the 
cutis.     The  intestines  are  liable  to  gangrene  and  mortification 

t  These  appearances  succeed  ideopathic  dysentery  ;  no  instances  exist- 
jtd  within  ray  observation,  where  tliey  were  cxiiibited  among  the  dysenter- 
ic patients  of  the  army. 

*  Pcybala  have  been  noticed  but  seldom  in  domestic  practice  by  myself, 
and  never  in  hospital  practice,  where  the  disease  is  seeu  under  all  its  vari- 
<^vs  forsif. 


■■^'J 


I  ' 


I  I    llHlifKI 


ii 


282 


APFENDIX. 


from  excessive  inflamranlioii  hs  well  us  other  parts  of  the  tiodv  * 
nnd  as  it  hns  8ii|iervened  Hnd  l)eeii  noticed  Ity  ith,^  siciaiis,  lliej 
have  forined  an  ojtinion  th;it  (lyscntery  is  ii  Kiiigreuous  disordtr 
at  its  comnietioeineiit ;  and  <;(»vprnt'd  Uy  this  |>er8tt  laion,  have 
in  their  praetice  prc9c.ri!)rd  intdieine  to  obviate  ganirrene, 
rallier  than  the  real  state  of  tlie  diae  ise.  Hence  we  lind  sliinu- 
lants  [(rescrilied,  insU.id  of  the  more  approjiriate  anlipfdogislic 
Tegiinen,  at  the  first  altacU  of  the  disease. 

Pus  has  been  noticed  in  tlie  evacuations  in  the  last  stnce  of 
dysentery.  Hence  arises  tlie  |)reposteroii8  and  inert  practice 
of  administering  tranmatics  to  the  exclusion  of  more  elTicieut 
remedies  at  tlie  commencement  of  the  diaease.f 

Tlie  fecal  materials  voided  are,  at  times,  iirown  or  Idack; 
upon  which  has  been  established  an  erroneous  palholo;;y,  that 
l»ile,  or  its  vitiated  state,  is  the  formidable  cause  of  all  the  evils 
attendant  on  the  dysentery,  us  well  as  oilier  dist-oisca.^' 

In  some  states  of  disease  there  is  a  copious  evacuation  of 
bloo<i  from  the  intestines.  This  has  never  been  noticed  by  my- 
felf  when  it  was  accom[)anied  with  genuine  dysenteric  symp- 
toms, as  gripes  and  tenesmus,  it  is  mentioned  however  by  au- 
tliors.  MosELEV  says  he  has  seen  blood  evacuated  iu  dysentery 
in  torrents,  as  from  a  wound.  Whenever  I  have  observed  dis- 
charges of  |)ure  unmixed  blood  from  the  intestines,  by  pints  and 
(quarts  at  one  evacuation  {  this  profusion  evinced  it  did  not  es- 

■)  It  lias  been  ascertained  by  many  dissections  in  the  liospitals  of  the  army, 
tliat  the  punilent  disclinrgos  in  dysentery  are  secretions  from  ulcers  within 
the  rectum,  the  consequence  of  inflammation. 


ill 


*  Notwithstanding  all  the  light  which  baa  been  given  npon  this  subject 
by  modern  writers,  yet  bile  is  still  charged  with  all  the  deleterious  eltl-cts 
of  diseases,  and  is  believed  to  be  more  productive  of  |)lagues  hul  and  cold  ;  of 
ic\ers  spoltul,  yellorc,  and  scarlet,  through  all  their  varying  shades  and  shapes, 
down  to  that  produced  by  rum  and  ichirkey.  That  salubrious  and  inoflfen- 
fiive  liquor  denominated  bile,  for  whose  bountiful  secretion  one  of  the  most 
tapacious  organs  of  the  human  body  is  wisely  appropriated,  is,  even  at  this 
«:niightened  period,  believed  to  be  mure  prolific  in  destructive  diseases 
which  alKict  mankind,  than  was  the  celebrated  Pandora's  box  among  ths 
ancients. 


APPENDIX. 


283 


oape  from  the  MoimI  veBsrIs  of  the  inteslinea ;  these  licing  too 
flimll  to  8U|i|>iy  the  quiuitity  voided.  Ilmce  it  wag  inferred, 
thia  astontghin^  flood  of  hlood  could  have  no  auurcc  but  the  liv- 
er;  from  thence  the  blood  is  nipposed  to  pass  through  the  due** 
tiis  cbohdociiB  into  the  duodenum.  The  state  of  this  important 
orjran  so  necessary  to  di^restion  and  healthy  action  of  the  intes- 
tines, when  in  thit  condition  which  permits  its  vital  fluid  to  pass 
ofl"  in  torrents,  will  be  hereafter  explained. 

Whenever  in  the  course  of  the  <lisease  the  evacuations  frorai 
the  bowels  exhibit  natural  afjpearances,  tliere  is  a  remission  of 
all  the  violent  sym,>tom0.  Severe  gripes  and  tenesmus  some- 
times abate  while  the  evacuations  assume  the  form  of  diarrliiua, 
or  H  lienteria,  wherein  the  nutriment  is  voided  in  the  same  state 
as  when  taken  into  the  stomach,  and  slides  through  tlie  intes- 
tines 81)  quickly,  that  it  appears  indii^estetl  or  unchanged. 

Thise  various  apfiearances,  formiTly  distinguished  by  ditfer- 
ent  appellations,  as  being  diiV^rent  diseases,  are  inlluenceil  by 
climate,  season  and  constitution  upon  the  disease  in  its  ditlereut 
stages  and  degrees  of  existing  disorder. 

The  danger  is  always  estimated  from  states  of  severe  pain  and 
debility  induced  by  mor!>id  effects  of  the  disease.  Unremitted 
gripes  with  most  frequent  and  inetfectual  elforls  to  evacuate  the 
contents  of  the  intestines;  swollen,  tense  abdomen,  cold  ex- 
tremities, indicate  death,  or  imminent  danger. 


CAUSES. 

Previous  to  n  consideration  of  the  causes  which  wc  believe 
active  in  producing  dysentery,  we  think  it  exj)edient  to  concise* 
]y  notice  the  o|)inion3  of  writers  upon  this  sulyect ;  and  shall,  at 
the  same  time,  take  the  freedom  to  controvert  such  as  appear 
objectionable;  and  with  much  deference  to  high  and  distinguish- 
ed authorities,  otfer  reasons  for  our  disseolioa  which  to  us  appear 
im|)orlant. 

Sydenham  supposes  that  dysentery  is  the  fever  of  the  season 
turned  in  upon  the  bowels.  This  sentiment  has  been  often  re- 
ferred to  by  writers  upon  this  subject.  As  this  disease  most 
generally  prevails  iu  those  seasons  when  autnmnai  fevers  are 


f 


i  ; 
1! 


Il 


284 


APPENDIX. 


M    1 


epidemic,  it  is  inferred  by  that  acciir  ile  obaerver  of  the  nature 
of  disensea,  and  their  chanj^es  depending;  on  trnnsitinns  or  sea- 
sons and  weather,  that  dysentery  and  these  fevers  have  one  com* 
inoii  cause.  Among  others  who  have  adopted  the  al>ov(>  opin- 
ion is  MosELEY  ;  who  has  adduced  an  additional  oltservution  to 
support  the  sentiment,  "  the  stools  are  more  frequent,  and  every 
symptom  of  the  disease  np^gravatcd  at  those  hours  when  these 
fevers  are  in  their  exacerbation."  "  This  fever  of  the  intestines 
like  most  other  fevers,^"  adds  Mobeley,  "  is  caused  by  obstruct- 
ed perspiration,  not  confined  to  cold,  wet  or  dry  seasons,  partic- 
ular food,  water,  or  fruit,  chiefly  depending  on  some  influence  of 
the  atmosphere,  or  sudden  transitions  of  the  air,  and  such  other 
causes  as  expose  people  to  have  their  perspiration  stopped.''  In 
order,  however,  to  assign  a  reason  why  one  part  of  the  body  be- 
comes affected  at  one  time,  and  a  ditferent  [lart  at  another,  from . 
the  same  cause ;  Moseley  finds  it  necessiiry  to  have  recourse 
to  a  conjunct  cause,  otherwise  "obstructed  perspiration,"  to  use 
his  own  language,  "  the  parent  of  so  many  diseases,  would  al- 
ways produce  the  same."  Mobelby  further  remarks,  "  as  he 
has  practised  in  the  opinion  that  this  fever  of  the  intestines  is 
caused  by  obstructed  pers{)iration,  so  he  universally  found  it  re- 
lieved by  turning  back  the  discharges  to  their  natural  channels." 

If  obstructed  perspiration  be  the  principal  cause  of  dysentery, 
it  may  be  aslted,  why  does  not  the  application  of  cold,  or  a  sud- 
den transition  from  heat  to  cold,  by  abstracting  heat  (caloric) 
from  the  body,  whereby  the  pores  are  closed  or  contracted  by 
spasm,  produce  this  disease,  at  every  season  of  tiie  year,  as  well 
as  the  autumnal  ? 

From  the  accuracy  of  Moseley's  observations  upon  most  sub- 
jects, one  would  suppose  several  circumstances  as  productive 
causes  of  dysentery  would  not  have  escaped  his  notice ;  viz. 
heat,  moisture,  filth,  and  vitiated  food ;  except  for  the  purpose 
of  supporting  a  favorite  doctrine.  Perhaps  we  all  are  disposed 
to  give  too  much  weight  to  a  simple  agent,  when  it  is  discover- 
ed to  be  deleterioub;  and  lose  sight  of  a  combination  of  causes 
most  productive  of  violent  epidemics  ;  sometimes  aa  elfeet  is  as- 
signed a  caose  of  disease. 


-j-m 


APPENDIX. 


28S 


•  HeHt  and  motiture,  fillh  and  vitiated  Tood  conjoinetl,  or  even 
fieveraliy,  rniiy  he  demonstrated  to  have  heen  more  active  in 
thR  i^enertttioii  of  violent  rormsordiaeaBe,  than  any  agent,  whicii 
is  unly  capiihle  of  obstructing  per8|>iration.  It  is  among  soldiers 
in  the  field  and  quarters,  thotfiltb  and  bad  provisions  abound.  It 
is  among  that  class  of  men,  that  dysentery  afipears  with  all  its 
hideous  Turms  ;  and  it  v/ai  among  these  that  Mosely  collected 
the  most  of  his  facts  upon  which  his  observations  are  founded. 

Cullen  says,  that*^  dysentery  often  arises  from  the  application 
of  cold,  and,  oflen  contagious  ;  that  by  propagation  of  such  con- 
tagion, independent  of  cold,  or  other  exciting  causes,  it  becomes 
epidemic  in  camjis  and  other  places,"  and  adds,  "  that  sjtecitie 
contagion  is  the  remote  cause  of  dysentery."  That  '♦  dysentery" 
is  a  contagious  disease,  passing  from  one  to  another  in  camps,  and 
from  soldiers  to  the  inhabitants  of  the  neighboring  villages,**  is 
also  an  opinion  of  Sir  John  Pringle,  who  further  observes,  "  this 
disease,  aeteris  paribus,  prevails  mostly  among  such,  as  are  of  a 
scorbutic,  that  is,  of  a  putrid  habit;  or  among  the  poorer  people, 
■who,  from  foul  air,  bad  diet,  and  nastiness,  are  most  liable  to  pa- 
trid  diseases." 

If  it  can  be  made  evident,  that  this  disease  may  be  produced 
hy  causes  independent  of  contagion,  where  is  the  consistency  or 
rationality  of  having  recourse  to  the  supposed  contagious  nature 
of  the  disease,  to  account  for  its  prevalence  in  those  seasons, 
even  when  it  is  epidemic  ?  A  supposition  more  philosophical  is, 
that  the  same  causes,  which  produce  an  epidemic  disease,  and 
give  its  form  to  a  single  patient,  may  continue  active  in  produc- 
ing a  similar  state  on  others.  Formerly  epidemic  diseases  were 
apprehended  to  have  been  propagated  mostly  by  contagion :  the 
doctrine  had  become  so  general,  that  even  common  coughs  were 
called  by  some  contagious.  But  in  cases,  where  a  disease  orig* 
in.tted  without  a  concurrence  of  known  communication  with  aa 
inlK'ted  person,  to  account  for  its  existence  physicians  resorted 
to  cold,  heat,  nastiness,  putrid  effluvia,  marsh  miasmata,  obstruct- 
ed fiersjMration,  or  some  secret  agent  ef  darkness ;  but  the  dis- 
ease h.ving  been  fairly  introduced  into  community,  all  the  as- 
signed causes  of  its  first  existence  arc  forgotten^  aad  no  loDger 

•37 


J^-.> 


r   ' 


il 


fitO 


APPENDIX. 


mentioned.  The  multitude  hope  to  escape  diienie,  by  avoids 
iniK  the  lick ;  while  at  the  lame  tinae  they  cherish  altout  them* 
•elvei  many  of  the  active  cautei,  and  hug  to  the  last  the  most 

lataK  *'        -<ri.»<r  iMf  .:  .ni     'nlr^ii  f "  i<>  >f    ■  •    k.    .       a, 

"  The  doctrines  of  contagion  and  infection^  and  the  scientific 
distinction  between  them  were  not  formerly,  it  is  apprehended, 
■o  well  understooil  as  at  the  present  dny.  This  interesting  sub- 
ject has  been  recently  treated  with  so  much  clearness  and  per- 
spicuity, in  that  valuable  collection  of  communications,  the 
Medical  RKPesiTORV,  and  is  therein  exhibited  in  so  luminous 
a  point  of  view,  that  we  deem  it  necessary  only  to  refer  the  read- 
er to  the  definitions  of  those  terms,  therein  found,  "  which,"  says 
the  author,  "  although  they  have  been  used  in  a  synonimous 
tense,  apiiear  to  a  mind,  in  the  habit  of  noticing  nature,  in  her 
diversitied  forms,  to  convey  very  different  and  distinct  ideas.' 

Diseases,  known  to  be  contagious,  as  small  pox  and  measles, 
are  propagated  t.t  all  seasons  of  the  year,  without  regard  to  tern* 
perature ;  whereas,  diseases,  which  depend  on  an  infected  air 
from  putrefofction  of  substances  in  a  state  of  decay,  or  on  local 
position  for  their  existence,  are  endemic  only  at  one  season. 
Dysentery  prevails  durkig  the  summer  months,  and  does  not  be- 
come  endemic  until  the  heat  of  the  weather  is  so  high  in  degree, 
as  to  generate  putrefaction  on  animal  and  vegetable  substances, 
in  a  state  of  decay  ;  this  disease  abates  or  disappears,  as  soon  as 
the  heat  of  the  season  decreases  to  the  line  of  frost.  Dysentery 
may  also  exist  during  winter,  in  crowded  prisons  and  hospitals, 
where  a  putrefactive  process  is  generated  from  hith  and  animal 
excretions.  [Note.  The  last  observation  is  added  since  the 
author  was  conversant  with  the  disease  during  the  winter 
months,  in  the  military  hospitals.  Under  these  circumstances, 
the  disease  was  considered  consecutive,  not  ideopathic.  It  was 
the  consequence  of  habitual  diarrhoea,  continued  from  its  first  ap* 
pearance  by  the  agency  of  those  causes  which  produced  it,  until 
the  rectum  became  excoriated  and  ulcerated.  If  dysentery  is 
generated  during  the  winter  months,  it  is  where  the  patient  is 
surrounded  with  animal  filth,  and  in  a  confined  state.] 


'•Jsl■'1^* 


II  IX 


APPENDIX. 


28f 


DiMftSci  are  eaniiderMi  epidemic,  when  they  spread  over  a 
0oiiiid»>rible  extent  of  country.  They  hnve  common  fymptoms, 
which  constitute  their  pathognomoaic  chiiractert.  Similar  caua- 
ea,  under  similar  circumatances,  are' proituctive  of  the  same  ef- 
fecta.  Diflerent  additional  causps  may,  and  do  often  coojierate 
to  diveraify  the  forma,  under  which  diseaaea  may  ap|tear.    '        * 

From  conaiderationa  to  he  adduced,  we  presume  to  say,  that 
one  immediiite  cause  of  an  epidemic  dysentery  is  the  proiiuctton 
of  putrefaction  in  a  i  ubtile  form,  or  gasseous  state  actinti;  imme- 
diately upon  the  alimentary  tu(>e.  tihould  it  be  c  introverted, 
that  invisible  passes  are  active  agents,  when  in  contact  with  ir« 
ritable  fibres,  we  enquire,  what  form  **  that  vitiated  product 
of  living  Vflscular  action"  assumes,  which  excites,  through  the 
Boeilium  of  the  air,  a  diseai^  like  that  by  which  itself  was  pro- 
duced, but  gasseous  ?  What  is  the  material,  expired  from  the 
lungs  of  a  {lerson  under  the  measles,  which  in  capable  of  commU' 
bicating  to  a  person  in  health  a  similar  disease,  except  gas  ? 
What  is  that  agent  which  abounds  in  nnventilated  prisons,  la 
dirty  hospitals,  in  foul  ships,  in  large  towns  and  populous  cities, 
filled  with  filth,  in  houses  stored  with  fish,  beef,  and  corruptible 
articles,  which  havo  been  known  to  have  been  active  in  the 
generation  of  disease,  but  the  oroduction  of  either  putrefaction, 
or  arifmal  decomposition,  or  animal  excretions  in  the  forms  of 
gas  ?  Do  the  emanations  from  substances  in  a  state  of  putrefac- 
tion assume  the  form  of  gas  ?  Are  offensive  productions  of  an- 
imal excretions  gasseous  ?  The  olfactory  nerves  of  f.very  one 
will  determine  the  question.  To  convince  ourselves,  that  more 
active  agents  cannot  be  found  to  generate  diseiases,  than  the  pro- 
duction of  putrefaction  and  animal  excretions,  it  is  unnecessary 
to  review  the  history  of  diseases  further  back  than  the  late  sum- 
mer and  autum>aal  epidemics  in  cities  and  in  the  field.  In 
9»11  cases  where  critical  examinations  have  been  made,  it  has 
been  dem''^'*trated  by  clear  elucidations,  that  the  prevalent  dis- 
eases had  their  sour  from  gasseous  materials,  eliminated  from 
either  the  animal  k^.  gdom,  or  vegetable  substances  in  a  state  of 
decaj* 


HM^/i^.t  -f «<*,«'..  ,t"*v. A. fj    t' 


'  >•/« 


''.i^iv^i-n 


i». 


.rvja^' 


^f^r 


«efl 


APPENDIX. 


i 


m 

[r'ii- 


CoUI  and  sudden  tran»Uion8  or  weather  from  a  ho(  to-  a  colder 
ttate  of  atmosphere,  are  considered  as  exciting  causes  of  dysente* 
ry,  co-operatiag  with  the  more  etlicient,  which  give  the  form  of 
the  disease.  Great  variations  of  weather  co-operate  with  all 
the  hurtful  agents,  during  every  season  of  the  year.  But 
the  cold  seasons  do  not  generate  epidemic  dysentery,  inde- 
pendent of  other  causes.  Is  it  remarkable,  that  dysentery  suc- 
ceeds sudden  variations  of  weather,  without  the  co-operation  of 
other  active  agents?  It  has  been  observed,  that  this  di:»ease  is 
mostly  epidemic  in  that  season,  and  those  years,  when  there  is 
the  least  variation  ;  when  the  hot  season  continues  during  a  long 
period,  with  little  variation. 

Heat  may  be  considered  an  immediate  exciting  cause  of  dys- 
entery, as  well  as  mediate.  An  imnudiate  exciting  cause^  by  in- 
creasing the  irritability  of  the  body,  or  rendering  it  more  sus- 
ceptible of  active  <«timulants,  and  thus  co-operating  with  delete- 
rioui!  agents.  An  over  proportion  of  caloric  induces  morbid  ex- 
citability ;  to  support  the  health  of  the  body,  due  degrees  of  that 
powerful  agent  are  necessary,  r.  js**  ,  -^j^fa*  aw,  w»t. ;s  ijiiiR  :m. ;  k\- 

It  is  to  be  observed,  that  heat,  also,  is  a  mediate^  or  more  re- 
mote cause  of  this  disease,  by  a  combination  with  moisture,  act- 
ing upon  vegetable  and  anima!  substances  in  a  state  of  decay, 
favourable  to  a  putrefactive  process.      ?i«mr»-^*smj t'^p  ■rrfvw     . 

During  the  hot  seasons  of  the  year,  an  extensive  section  of  a 
country  may  abound  witli  deleterious  agents,  productions  of  pu- 
trefaction, so  as  to  generate  dysentery ;  which,  from  its  general 
prevalence,  may  be  denominated  endemic.  From  the  records 
of  endemic  diseases,  evidence  of  the  above  position  may  be 
drawn.  A  diseased  action  of  the  organs  of  digestion,  effects  of 
intemperance,  may  induce  in  the  alimentary  canal  morbid  agents 
liberated  by  the  process  of  putrefaction,  and  produce  inflamma- 
tion and  ail  the  symptoms  of  dysentery.  Provisions  in  a  taint- 
ed state,  "  replete  with  the  poison  of  putrefaction,''  may  be  eat- 
en by  numbers,  and  who,  at  the  same  time,  may  be  attacked 
xiith  this  disease.  These  last  conditions  will  be  denominated 
sporadic.  The  disease  may  originate  from  a  combination  of 
the  above  causes,  infected  air,  impaired  digestion,  human  ex- 


1:   > 


APPENDIX. 


2ftd 


oretfoiii,  and  comipted  provisions  taken  as  nutriment ;  nvi  pre* 
vail  under  forms  the  most  mortal.  Thus  geuerated,  it  frequent- 
ly appears  in  camps,  in  besieged  cities,  in  prisons  and  hospitals. 

A  question  may  be  usked,  in  what  manner  gasseous  poisons 
introduce  themselves  into  the  body  from  the  atmosphere  ?  The 
Air  impregnated  with  these  volatile  materials  may  be  conveyed 
to  the  stomach  with  the"  saliva  and  nutriment  in  the  act  of  deglu- 
tition ;  thence  into  the  intestines.  It  is  most  evidentsthat  these 
organs  are  firimarily  diseased,  as  if  some  poison  had  been  swal- 
lowed. All  the  symptoms  of  morbid  action,  nausea,  vomitings 
and  gripes  demonstrate  it ;  more  particularly  inflammation  and 
ulceration  of  the  intestines,  when  the  disease  is  not  cured  in  its 
early  stage.  The  increased  heat  upon  the  surface,  and  obstruct- 
ed pers|nration,  which  are  among  the  first  symptoms,  are  the  ef- 
fects of  association,  not  the  causes  of  the  disease.  Such  is  the 
connexion  between  the  internal  viscera  and  the  skin,  that  the  dis- 
eased actions  of  the  last  are  intimately  connected  with  the  mor* 
bid  condition  of  the  former. 

If,  as  has  been  adduced,  epidemics  are  all  caused  by  the  same 
exciting  agents,  it  becomes  a  subject  for  enquiry,  how  the  same 
cause,  at  one  time  is  productive  of  fevers  A  another  time  dt^seri' 
fCT^,  and  at  a  third,  cKorr^a.        »-»»   *-"■    *»Hii«*t'rt*i.  :r  •*  «j 

We  reply,  that  when  the  hurtful  agents  are  absorbed  into  the 
pulmonic  vessels,  through  the  thin  membranes  of  the  lungs  with 
the  oxygen,  and  there  united  with  the  blood,  thence  conveyed 
to  tlie  heart,  they  become  a  direct  stimulus  to  that  organ  and 
the  arterial  system ;  when  a  fever  will  he  the  effect.  When  the 
poisonous  cause  of  diseased  action  is  conveyed  to  the  stomnch 
and  intestines,  by  deglutition,  or  in  the  act  of  swallowing  our  sa- 
liva, a  dysentery  may  he  the  consequence  ;  while  a  fever  which 
accompanies  it  will  be  a  secondary  effect.  But  when  the  dis- 
ease-generating-principles  in  their  progress  through  the  intes- 
tines, stimulate  the  gall  duct,  a  flow  of  bile  is  thereby  produced, 
and  meeting  the  offending  cause,  a  salutary  diarrkcea  may  fol- 
low, which  in  its  progress  may  wash  from  the  canal  tlie  foul  ma- 
terials ;  when  a  natural  cure  may  be  effected.""^    It  is  further  to 

■      •  Medical  »epolitor^     ^m.^.^----'  ?X.t.^;^   .;■.,>;/ ■.•,-.^,.>^;-v^:f 


■.. '  1 


7^7^ 


eta 


APPENDIX. 


'  I 


i 


be  unckntood,  these  hurtful  agent*,  under  some*  circumstances* 
find  access  ta  the  important  organs  of  life,  through  all  the  ave- 
xuies  of  the  animal  system. 

Dissection*  have  given  us  a  clearer  view  of  the  diseased 
conditions  of  the  intestines.  In  some  cases  they  have  been 
found  ulcerated,  or  in  high  states  of  inflammation ;  in  others,  in, 
a  state  of  gangrene  and  mortification,    n^nio  «n/#  \ifiit  m(^^.^m^^*i* 

These  morbid  states,  connected  with  the  several  forms  and 
symptoms  of  the  disease,  direct  us  to  the  nature  of  the  offending 
causes,  which  are  lodged  within  the  alimentary  canal.  From 
the  morbid  effects  produced,  they  are  believed  to  be  of  a  caus> 
tie,  or  irritating  quality.  That  their  irritating  property  depends 
on  acidity,  is  presumed  from  the  well  known  beneficial  effects  of 
neutralisers  of  acids  in  this  disease ;  and  for  a  curative  indica- 
tion it  is  immaterial  whether  the  offending  principle,  denomi* 
nated  acidities,  is  cause  or  effect. 

From  the  diseased  state  of  the  alimentary  organs  in  dyseutery, 
and  the  combination  of  morbid  actions,  as  symtomi  associated 
Xiith  it>  our  indications  of  cure  are  obvious. 


.-r*:  i*^ 


.•(V'Hjvv,. 


.v>w 


TREATMENT. 


v^,,f  * 


Having  delineated  the  several  forms  under  which  dysentery 
appears,  and  concisely  stated,  what  are  believed  to  be  the  cau- 
ses of  the  varieties,  under  which  this  disease  commences  ;  also, 
what  are  supposed  the  general  causes ;  and  as  it  is  apprehended, 
these  varieties  are  principally  "  influenced  by  climate,  seasons 
and  constitution,  upon  the  disease,  in  different  stages  and  degrees 
of  it ;"  there  will,  in  the  curative  indications,  be  considered  two 
general  states,  or  conditions  of  the  disease ;  and  under  each  be 
comprehended  such  varieties,  as  require  particular  methods  of 
treatment. 

I.  When  the  disease  is  accompanied  with  heat,  and  a  strong 
action  of  the  arterial  system  of  vessels,  denoting  a  a^nochal  state. 

II.  When  the  dise^ise  assumes  a  weak  action  of  the  heart  and. 
arteries,  with  languor  and  coldness,  indicating  a  tjfphoid  state. 

A.  When  this  disease  is  accompanied  with  high  degrees  of  heat^ 
strong  action  of  the  arterial  system,  severe  gripes  and  tenesmus ; 


it 


APPENDIX. 


2tfl 


; , ! 


61eediHK  is  indicated.  From  much  experieiioe  we  are  convioi 
cedf  that  this  is  a  remedy  of  too  much  importance  to  be  omitted. 
By  immediately  abstracting  Trom  the  body  a  quantity  of  stimu- 
lus, by  blood-letting,  heat  is  reduced,  and  pain  mitigated.  Bleed- 
ing is  a  well  known  mean  of  subduing  inflammation,  which  con- 
stitutes the  disease.  It  is  not  always  the  case  that  inflamma> 
tion  of  the  intestines  exhibits  itself  by  a  rtrong  and  full  pulse. 
Inflammation  of  the  stomach  as  well  as  bowels,  is  usually  ac- 
companied wii  mall  action  of  the  arteries,  or  rather  contracted 
and  hard  pulse,  at  the  same  time,  with  no  remarkable  increased 
heat  on  the  skin.  This  circumstance  seems  to  contra-indicate 
the  use  of  the  lancet.  Its  employment,  notwithstanding  these 
appearances,  is  often  as  necessary  in  dysentery  with  the  last  de- 
scribed symptoms,  as  in  pneumonia,  with  pain  and  great  heat. 
Severe  dysenteric  symptoms,  at  their  commencement,  have 
been  known  to  have  been  removed  by  one  copious  bleeding ; 
and  we  have  the  practice  of  most  celebrated  authors  upun  the 
subject  to  justify  its  recommendation. 

B.  Remedies  employed  after  venesection,  are  such  as  operate 
directly  upon  the  diseased  organs,  by  exyelling  or  counteracting 
the  causes  of  derangement.  They  are  cathartics  and  emetics. 
Tlie  most  violent  forms  of  dysentery  require  the  most  prompt 
evacuations  by  the  bowels,  at  the  first  attack  of  disease.  Ca- 
thartics should  be  administered  in  full  dosea,  so  as  to  promote 
quick  and  thorough  operations.  From  that  class  of  medicine^ 
which  accelerates  the  peristaltic  motion  of  the  intestines,  we  se- 
lect those  articles,  which  purge  effectually,  with  the  least  irrita- 
tion, and  occasion  little  or  no  gripings,  viz.  sulphate  of  soda, 
(glaubers  salts ;)  sulphate  of  potash,  (vitriolated  tartar;)  oil  of 
castor.  Submuriate  of  quicksilver,  (calomel)  is  also  employed 
m  full  doses  for  a  cathartic.  Jalap  and  calomel  combined,  is  a 
favorite  cathartic  with  some  physicians  on  robust  patients.  .  Ca- 
thartics are  to  be  employed,  until  the  urgent  symptoms  of  in- 
flammation are.  abated.  In  idiopathic  dysentery,  little  besides 
cathartics  is  necessary ;  for  the  disease  is  overcome  in  robust 
habits,  as  soon  as  the  bowels  are  evacuated  ;  when  the  appetite 
returns  without  any  excitements.    But  after  full  (tvacuationst 


r"f 


"■t 


^Y^ 


202 


APPENDIX. 


If  i 


M 


?i 


) ' 


UM-. 


m. 


the  disease  eontiouing,  calomel,  with  or  without  opium,  as  sym{» 
toms  demnnd,  are  admioistered ;  and  in  obstinate  Cases,  are  con* 
tinued  until  a  sore  mouth,  or  gentle  ptyalism  is  induced.  It  has 
been  frequently  noticed,  that  as  soon  as  the  last  effect  has  heeu 
produced,  the  disease  removes,  or  is  mitigated.  Ulcerations  of 
abrasions  having  sujiervened,  experience  has  proved,  that  calo^ 
mel  is  a  doubtful  medicine.  Our  practice  in  the  army,  demon- 
strated the  correctness  of  the  preceding  observation.  '  • 

c.  Emetics  are  indicated,  in  cases  where  nausea  and  vomiting 
exist,  dunng  the  commencement  of  this  disease.  Tartrlte  of 
antimony,  (tartris  antimon.)  and  ipecacuanha  are  severally  or 
jointly  administered.  The  first  of  these  emetics,  in  cases  where 
the  patient  is  robust ;  the  last,  where  delicate.  Emetics  not 
only  evacuate  offending  materials  from  the  stomach,  but  promote 
the  secretions  in  general,  particularly  those  of  the  liver  and  skin. 
It  has  not  escaped  the  observations  of  physicians,  whenever  a 
full  flow  of  bile  follows  the  use  of  emetics  or  cathartics,  the  vio- 
lent symptoms  of  this  disease  abate.  A  gentle  perspiration  suc- 
ceeding any  means  employed,  is  considered  a  salutary  symptom. 

D.  In  cases  where  there  is  deficiency  of  bile,  evidenced  by 
the  absence  >  vellownes  in  the  evacuations,  by  cardialgia,  acid 
eructations,  and  sensations  of  heat  in  the  stomach ;  the  follow- 
ing neutralizers  of  acids,  magnesia,  chalk,  and  lime-water,  have 
been  employed,  and  not  without  benefit ;  but  it  has  been  expe- 
rienced, that  he  weaker  correctors  of  acidities  are  ineffectual 
in  all  cases ;  and  physicians  of  late  are  more  in  the  use  of  alka- 
lies, soda  and  potassa.  Alkalies,  it  is  to  be  observed,  should  be 
employed  in  very  diluted  states,  because  when  unneutralized, 
they  aggravate,  by  their  stimulating  properties,  the  inflammation 
and  pain  in  the  bowels,  when  administered  in  quantity,  greater 
than  necessary  to  neutralize  the  existent  acidities.  Doses  are  to 
be  regulated  by  effects  produced.     '  ■-«>   '"'  •   *       •     >  •>  i-i*.  i 

E.  Gripes  and  tenesmus,  the  most  urgent  symptoms  of  the  dis- 
ease, seem  to  demand  the  employment  of  anodynes,  in  the 
use  of  these,  much  cautior  is  to  be  exercised ;  and  we  should 
be  under  some  restriction^  in  their  administration.  Although 
the  violence  of  the  above  symptoms,  is,  for  a  time,  mitigated  hj 


fl!  1 


dis- 

the 

liould 

)ugh 

[dby 


APf*ENDtX* 


-..Pi 
1293 


i!"!f 


«ftitini,  yet,  evacuations  or  the  aHmentary  canal  previous  to 
their  employment,  are  enjoined.  By  experieb«'.e,  yie  are  con- 
vinced, that  as  soon  as  the  pacific  etfecis  of  opium  cease,  (aiio» 
dynes  having  been  employed,  previous  to  suitable  evacuations,) 
the  gripes  and  tenesmus  occur,  and  often  with  increased  force, 
from  the  retention  and  consequent  accumulation  of  the  offend- 
ing agents  within  the  alimentary  tube.  The  intestines,  how- 
ever, having  been  well  evacuated,  or  the  vitiating  materials 
therein  corrected,  by  the  several  means  above  recommended, 
opium  becomes  an  indispensable  remedy. 

The  beneficial  effects  of  opium,  in  the  synochal  state  of  dys- 
entery, are  sometimes  increased  by  calomel  in  small  doses.  By 
their  joint  operation,  a  Icind  of  neutral  effect  is  produced.  The 
cathartic  property  of  one  obviates  the  restriction  occasioned  by 
the  other ;  so  as  while  pain  and  tenesmus  are  mitigated  by  the 
anodyne  effects  of  opium,  the  peristaltic  action  of  the  intestines 
fe  preserved  by  the  calomel.         '  ^'IJ   -•'   »  >  .»*  ' 

If.  When  the  disease  assumes  a  weak  action  of  the  heart  and 
arteries  with  languor  and  coldness,  indicating  a  typhoid  state. 

A.  In  this  state,  bleeding,  either  at  the  commencement,  or  ia 
a  more  advanced  stage  of  the  disease,  is  unnecessary.  Injuri- 
•us  consequences  may  follow  its  employment. 
•  B.  Cathartics,  however,  are  indicated,  for  the  same  intentions 
as  in  the  synochal,  especially,  where  previous  evacuations  have- 
not  been  made.  Those  cathartics  already  enumerated,  as  prop- 
er in  the  synochal  state  of  the  disease,  may  be  employed  here* 
where  the  vigour  of  the  system,  and  strength  of  the  stomach 
will  admit  of  their  use.  But  here,  as  no  specific  directions  eaa 
be  pointed  out  for  every  case,  the  judgment  of  the  prescribing 
physician  must  dictate.  As  this  state  however  is  often  accon»> 
panied  with  extreme  debility  and  irritability  of  the  stomach,  in- 
asmuch as  it  frequently  rejects  every  article  received ;  no  pre* 
scription  fulfils  the  intention  of  an  evacuant  so  kindly,  as  a  so- 
lution of  manna,  and  cream  of  tartar,  (super  tartrite  of  potash,) 
or  soluble  tartar,  (tartrite  of  potash,)  administered  at  short  inter- 
vals, i  Ofies  which  will  not  excite  vomiting,  until  the  propo8»> 
ed  end  is  effected.  No  cathartic,  in  oases  of  nausea  or  vomi^ 
3S 


II 


1 1 


!,,      .1 


I     i! 


ii 


29'4 


APPENDIX. 


'n 


iag,  is  leas  alTensivc  to  the  stomach  ;  wliile  it  may  vrith  safety 
be  received  in  quantity  sutAcient  to  prove  operative,  even  in  ca> 
ses  of  extreme  debility.  ,  ; 

c.  Emetics  of  ipecacuanha  are  occasionally  employed  in  this 
state,  as  well  as  in  the  synoclial ;  the  doses  should  be  regulated, 
80  as  to  produce  one  or  two  ejections  pt  a  time ;  and  if  necessa- 
ry, may  lie  repealed  every  day,  or  every  second  day.  We 
choose  the  morning  for  their  administration,  while  the  patient  is 
in  bed.  A  smaller  dose  will  answer  the  intention  of  an  emetic, 
at  that  time,  in  consequence  of  increase  of  sensci'ial  power  dur- 
ing sleep.  (See  Darwin.)  Emetics  \ivove  more  diaphoretic, 
and  determine  the  mnterial  of  perspiration  to  the  skin  most  ef- 
fectually, while  the  patient  is  in  bed. 

D.  Alkalies  in  diluted  states  are  employed  in  this  state  of 
dysentery.  To  render  them  more  agreeable  to  the  palate, 
and  accommodating  to  the  nauseated  stomach,  (for  nausea,  gen- 
erally, accompanies  the  typhoid  slate  of  dysentery,)  they  are 
Joined  to  weak  aromatics  and  bitters  in  decoction,  or  infusion ; 
viz.  serp.  virgin,  (aristolochia  serpentarin ;)  Colombo.  By  these 
raeans,  we  artificially  furnish  the  intestines  with  the  soda  and 
the  bitter  of  bile. 

E.  Blisters  are  found  beneficial  in  the  typlioid  state  of  dys- 
entery. In  the  synoclial,  they  are  seldom  necessary.  In  cases 
of  most  obstinate  pain,  by  making  a  derivation  from  tlie  diseased 
viscera,  or  by  their  counter-stimulus,  they  remove  spasm,  and 
Rvert  danger.  When  applied  in  cases  of  debility  upon  the  epi- 
gastric^ or  umbilical  regions,  they  not  only  mitigate  pain,  but 
check  nausea  and  vomiting.  In  states  of  languor,  and  where 
coldness  has  supervened,  their  afiplication  upon  the  extremities 
are  important ;  while  the  daily  repetition  of  one  is  beneficial  to 
excite  the  torpid  system,  and  support  the  powers  of  life,  sinking 
under  the  weight  of  disease. 

F.  Opium  has  been,  and  is,  at  this  time,  on  account  of  its  re- 
strictive powers,  employed  as  the  principal  remedy  for  the  cure 
of  dysentery  by  some  physicians.  It  is  our  opinion,  we  should 
be  under  restrictions  even  in  a  typhoid  state  of  the  disease,  as 
to  its  employment.    Previous  to  which,  evacucilions  are  nece?-- 


1: 


APPENDIX, 


20$ 


«aiy;  while  «ometimes  after  it»  anodyne  efTects  are  over,  a  rcii- 
etition  oT  eccoprotics  is  demanded,  l.i  many  cases  opium  be>- 
comes  im|H>rtant,  by  procuring  ease  and  sleep ;  and  seemn  to 
invigorate  the  body  worn  out  by  tenesmus. 

0.  The  tepid  bath  has  been  advnntngeoui  ly  employed  ia  some 
•tates  or  dysentery.  3t  admirably  co-operatos  with  opium  to  re- 
move spasm  and  pain.  The  bath  relaxes  the  vessels  upon  th' 
aurt'ace,  which,  by  association  with  the  int^^stines,  mitigates 
griping  pains  within  them.  It  also  equalises,  by  its  diffusive  ef« 
fects,  the  excitement  throughout  the  animal  system. 

H.  Mucilageki,  prepared  from  the  farioaeea,  the  gums  and 
woods,  are  auxiliaries  m  the  cure  of  every  condition  of  dysen' 
tery.  In  severe  cases,  at  the  commencement  of  the  disease, 
these  soft  articles  may  be  taken  in  large  quantities.  Frcm  a 
vast  variety  at  conHn:md,  the  judicious  physician  has  an  oppor- 
tunity to  make  bis  selection. 

1.  Enemas,  prepared  with  the  mucilages,  are  often  employed 
ivith  much  advantage,  in  cases  of  extreme  irritability  of  the  in- 
testines. Where  tenesmus  is  a  very  diatrcsstng  symptom,  we 
add  laudanum  to  these  mucilaginous  enemas.  ^ 

K.  After  evacuations  have  been  employed,  and  pain  and  in- 
IBammation  overcome  by  the  various  means  above  mention- 
ed ;  and  where  the  dyspeptic  symptoms  shew  the  inactive 
condition  of  the  stomach  and  other  organs,  subservient  to  diges- 
tion ;  physicians  have  employed  the  cortex  peruvianus,  (chin- 
chona,)  astringents  and  bitters*  We  are  not  however  convin- 
ced from  experience,  a  preference  is  to  be  given  to  any  one  of 
these  classes  of  medicine ;  which^  by  authors,  have  been  sup- 
posed specific  remedies  in  dysentery.  Astringents  and  bitter? 
may  be  of  use  under  some  circumstances.  In  whatever  manner 
these  medicines  act,  to  give  tone  to  the  stomach  and  intestines, 
when  in  a  condition  to  receive  them ;  they  should  be  cautiously 
employed,  on  account  of  the  increased  irritabiHty  of  the  alimen- 
tary canal  in  this  disease.  Where  stimulants  are  demanded  to 
support  the  action  of  the  system  of  vessels,  in  the  last  and  sink- 
ing stage  of  this  disease,  we  administer  wine  in  small  doses,  but 
frequently  and  with  moderation ;  adapting  the  cia«uuty  to  th< 
state  of  debility,  and  excitability. 


II 


T^ 


260 


APPENDIX. 


I 


« 


i  t' 


'llil 


I    1 


Ij.  Diarrhosa  and  lienteria  sotnelimefl  auume  the  place  of 
dysentery.*  In  these  cases,  more  depeadeace  ia  to  be  placed 
U|)Oii  opium  and  ipecacuanha  combined,  than  upon  astriiiKenta 
and  bitters.  Small  and  repeated  dosev  of  Ipecacuanha,  so  as  to 
excite  vomiting,  are  found  useful :  a  small  efrietic  every  twen- 
ty-four hours,  for  a  few  days.  Anoilynes,  fre(|uently  repeated  in 
small  doses,  are  preferable  to  full  doses,  at  long  intervals. 

M.  In  the  apthoua  state  of  dysentery,  we  recommend  the  trial 
of  blood-root,  (sanguinaria  canadense ;)  also,  raarsh  rosemary, 
(Statice  Limonium.)  From  the  above  medieiue  we  have  expe- 
rienced benefit.  They  are  generally  employed  in  decoction,  or 
infusion.  In  one  case,  where  from  soreness  of  the  mouth,  fau- 
ces and  throat,  swallowing  was  difficult ;  and  from  extreme  irri- 
tability of  the  stomach,  it  rejected  most  articles;  a  tea-spoonful 
of  olive  oil  was  admi(ustered  every  Qfteen  minujtes  for  twenty- 
four  houni,  and  after,  at  intervals  somewhat  longer,  in  larger 
quantity ;  and  was  thus  continued  several  days.  This,  with 
some  soft  nutriment,  was  supposed  to  be  a  mean  of  preserving 
life,  and  Bnally  of  restoring  the  patient  to  health. 

N.  In  cal^s,  where  blood  unmixed  is  evacuated  in  profusion, 
opium,  bark  and  wine  are  among  the  principal  remedies.  This 
state  of  disease  is  not  accompanied  wiM)  pain ;  wherefore,  abra- 
sions are  not  here  suspected.  The  livef  is  believed  the  source 
from  which  the  blood  flows.  In  these  cases  of  active  intestinal 
hemorrhages,  the  mineral  astringents  have  been  employed  with 
much  success ;  acetite  of  lead,  (acetas  plumbi ;)  vitriol  of  zinc, 
(sulphas  zinci.)  As  it  is  highly  probable,  that  these  discharges 
of  blood  are  from  the  liver,  would  a  blister  upon  the  region  of 
this  viacus  be  of  service,  to  remove  its  torpidity  ? 

DIETETIC  MANAGEMENT. 

In  dysentery,  the  diet  is  to  be  regulated  by  the  state  of  the 
disease.  In  all  cases,  the  nutriment  sliould  consist  principally  of 
the  firinaceous  preparations;  viz.  rice, sago,  salep,  gruels  prepar- 
ed from  the  flour  of  the  various  species  of  corn,  &c.    So  dispos- 

*  In  the  practice  of  the  army,  we  experienced  dyEcateric  symptcms,  ^ 
torn^cnting  gripes,  and  tenesmui  to  succeed  diarrlift*.  '     ^■vi'r.--  -  -;. 


i  Bg'.-U. 

f 

k 

ti.,  _.  ■, . 

APPENDiat 


aQ7 


ed  U  the  alimcDtar^  eanal  to  favor  the  putrefactive  process  with- 
in it,  on  account  of  the  defiriency  of  bile  and  gastric  liquors, 
as  well  M  excessive  inflammation ;  animal  nutriment  is  to  be 
prohibited  the  patient.  After  the  disease  is  mitigated  or  re-, 
moved,  and  appetite  restored,  c  vegetable  diet  with  inilk  should 
be  continued  during  a  statfe  of  convalescenry.  Relapses  have 
been  known  t«  succeed  an  indulgence  of  animal  nutriment, 
even  in  a  liquid  form.*,^^,^  .^  fv,,^,  ...jiyfj  vr.'Tf^tvr  ir^-^^  ,;fjrf"* 
Where  stimulants  higher  in  degree  than  simple  vegetable  nu- 
triment are  demanded  to  support  the  powers  of  life,  wine  is  the 
most  appropriate.  In  all  sta<es  of  these  disorders  of  thb  bow* 
els,  simplicity  of  diet  is  to  be  studied;  the  less  com|)ounded  and 
multiplied  the  regimen,  the  grei«'er  success  may  be  expected.§ 

PRACTICAIi  REMARKS   AND    OBSERVATIONS. 


Ist.  Physicians,  conversant  with  dysentery,  may  have  obser^ 
Ted  at  the  first  onset  of  the  disease,  where  there  is  great  heat 
ant}  strength,  the  doses  of  cathartics  are  required  to  be  larger, 
than  in  most  other  diseases.  By  early  and  timely  evacua- 
tions, the  feculent,  corruptible  contents  of  the  intestinal  canal 
are  discharged  before  its  coats  are  extremely  diseased,  and  the 
constitution  weakened.  The  more  thorough  the  cathartic  op- 
erations in  the  commencement  of  the  disease  are,  the  less  fre- 
quent the  diseased  tenesmal  efforts,  and  less  severe  the  gripes. 
There  are,  after  full  dejections,  always  longer  intermissions  of 
pain. 

2nd.  The  morbid  action  of  the  intestines  should  not  be  mis- 
taken for  the  operation  of  purgatives.  The  declarations  of  ig- 
uorant  nurses  are  not  to  be  depended  upon,  respecting  evacua- 
,tions  from  the  bowels.    Physicians,  after  the  exhibition  of  ca- 

*  Among  the  soldiers  on  the  frontiers,  no  article  of  diet  agreed  with  the 
sick,  under  diarrluea,  and  dyKnteric  symptoms,  so  well  as  milk,  and  its 
preparations  in  the  form  of  porridge.        >,■•  <»./«>«.' «,4f'>  .t.:  vm  its.r^inaiK' 

9  Army  patients,  with  chronic  diarrboda,  were  supported  a  long  time, 
with  diluted  brandy,  and  opium  occasionally;  u  addition  to  the  above  soft 
jvatrimeol.  •  •;   "  I 


yr" 


f 


►       H: 


'!li 


3Bi  APPENDIX 

thartlet,  should  examine  the  ttooli  to  satisfy  thenuelvet,  iwheth- 
er  a  cathartic  has  performed  its  office. 

3d.  The  most  drastic  purges  are  not  best  adapted  to  the  in- 
flamed state  of  the  inner  coals  of  the  intestines  in  dysentery. 
Irritating  purges  are  not  retained  upon  the  stomach  in  mauy 
cases ;  and  if  they  are  retained,  the  effects  of  their  stimulating 
properties  continue  a  greater  length  of  time  upon  the  intestiues, 
4han  neutral  purging  salts,  or  oil  of  castor ;  wrhich  operate  quick 
and  with  little  pain.  In  divrrhoea  and  lienteria,  rhubarb,  (rheum) 
in  small  doses,  combined  with  magnesia,  or  chalk,  has  been  ad- 
ministered by  physicians,  upon  supposition  that  in  addition  to 
its  cathartic  property,  it  irossesses  considerable  restrictive  pow- 
ers, noticed  by  the  costive  state  which  succeeds  its  cathartic- 
operation. 

4th.  Antiraonial  emetics  should  be  con(\ne<l  to  patients  of  ro- 
bust habits,  while  the  disease  is  accompanied  with  heat  and 
liigh  inflammation.    The  active  antimonial  preparations  oper- 
ate severely  upon  the  intestines,  under  high  states  of  excitability 
from  inflammation,  or  under  states  of  debility.     The  glass  of  an* 
timony,  (oxidum  antimonii  cum  sulphure  virtrificatum)  should 
be  employed  with  much  caution.     This  last  antimonial  prepa- 
ration had  acquired  much  of  its  reputation  in  the  cure  of  dysen- 
tery, among  that  class  of  men,  whose  systems  had  become  firm, 
and  fibres  rigid  by  hardships  long  endured.     Among  patients  of 
every  description  and  age,  it  should  not  be  employed.    *'  After 
the  cerated  glass  of  antimony  had  Inten  introduced  into  practice, 
its  reputation  spread  in  Europe ;  but  from  the  unguarded  manner 
of  giving  it,  while  the  patient  was  exposed,  it  was  always  dan- 
gerous, and  sunk  into  discredit.**     The  last  observation  was 
quoted  from  Pringle's  diseases  of  the  army.*    Hillort  ob- 
serves, "  though  it  may  be  a  good  medicine  when  properly  tim- 
ed ;  yet,  as  it  is  frequently  and  promiscuously  given  in  this  dis- 
ease, and  under  all  circumstances,  it  cannot  succeed.**    Doctoi^ 
MosELEV  says,  "  he  gave  to  a  soldier  three  grains  of  glaai  of  an- 

*  We  havft  hud  occasion  to  protest  against  the  employment  of  antimoni; 
als,  in  the  field  practice  of  our  armies. 


APPENDIlH 


209 


llmonj,  Rnelf  powdered,  made  ioto  a  pill,  in  the  wont  eonditlon 
of  dyientery,  with  blood  runoing  rrom  him,  a*  an  hemorrhage 
fVomawound;  It  operated  upwards  and  downwards;  a  violent 
sweat  ensaed ;  which  was  kept  up  by  warn  herb  teas,  am'  small 
doses  of  laudanum ;  which  last  is  given  with  safety  whi'  s  the  pa* 
tient  is  sweating ;  even  the  first  stool  after  sweating  began,  ha* 
been  less  bloody ;  tae  third  and  fourth  scarcely  tinged.**  Such 
he  says  is  ihe  power  of  revulsion.  Doctor  CuLLcrr  employs 
tartrite  of  antimony,  (tartris  antimonii)  in  small  doses;  andob* 
serves,  "  its  beneficial  effects  are  mostly  to  be  seen,  when  it  op- 
erates by  stool.**  If  the  principal  benefit,  expected  from  its  en^ 
ployment,  is  its  cathartic  operation,  it  should  with  other  active 
antimonials  give  place  to  those  purges,  whose  salutary  effectv 
are  more  certain,  and  danger  less  doubtful. 

5th.  Ipecacuanha  has  been  employed  either  as  an  emetic,  tit 
cathartic,  from  most  ancient  time  down  to  the  present,  in  the 
diseases  of  the  bowels.  Its  superior  efficacy  was  observed  by 
Piso ;  and  *'  where  the  evacuations  were  mixed  with  blood,"  ho 
resorted  to  this  medicine  "  as  a  sacred  anicer,  than  which  noth-< 
ing  was  more  safe  and  effectual.**  He  administered  this  drug  in 
all  fluxes,  after  the  following  prescription.  Two  drams  of  ipe^* 
cacuanha  were  directed  in  four  ounces  of  water;  one  ounce  of 
which  was  frequently  given  for  a  dose,  and  daily  repeated,  until 
the  disease  was  overcome.  Huxham  bagan  the  cure  of  this  dit> 
ease,  most  generally,  by  bleeding  and  ipecacuanha.  Tisson 
says,  that  tartrite  of  antimony  will  sometimes  cure ;  but  that  an 
emetic  of  ipecacuanha  is  not  less  efficacious ;  and  has  been  es* 
teemed  a  certain  specific  in  dysentery.  Beocklesbt,  on  diseases 
of  the  army,  says,  "  a  combination  of  two  grains  of  opium,  with 
three  of  ipecacuanha,  made  into  a  pill,  was  highly  beneficiaL^ 
Prinolg  also  attests  to  the  efficacy  of  this  medicine  administer^ 
eti,  so  as  to  operate  as  a  cathartic  ;  for  which  intention,  he  ad* 
.ministered  five  grains  every  hour  to  his  patients,  until  the  d«» 
sired  operation  was  produced.^ 


•r* . 


*  No  article  of  the  materia  mbdica  proved  equally  beneficial  and  lafe,  in 
cbronic  dysentery,  and  diarrhoea,  as  they  appeared  in  our  annici  on  thf 


I  i. 


300 


APPENDIX. 


i 


r 


)   I 


0tTi.  Aidfugents  have  been  employed  In  dfieiifHrjr,  npon  «q 
erroneous  opinion,  that  the  frequent  inclination  to  itool  is  the 
conieqaencf  of  immoderate  action  of  the  intestines,  the  efTerts  of 
debility ;  and  that  they  required  tonics  and  astringents  to  tt- 
strain  profuse  discharges.  Premature  administrations  of  this 
class  of  medicine,  we  are  confident,  have  been  productive  of  dan* 
ger ;  as  the  fecal  materia'is  are  thereby  confined,  and  inflamma- 
tion increased,  inducing  an  increased  tendency  to  gangrene 
and  morf^fication.*  In  the  convalescent  state  succeeding  dys< 
entcry,  and  where  tonics  may  with  safety  be  employed,  we 
have  not  succeeded  as  well  with  chinchona,  as  other  articles  of 
this  class  of  medicine.    -•«-""'.■.-     -—  .  ..h^.^.m. 

Physicians  in  the  United  States,  we  are  warranted  to  notice, 
have  not  experienced  the  same  efficacy  from  the  bark,  which 
British  writers  have  ascribed  to  it ;  and  have  been  disappointed 
in  it,  when  admini!>tered  agreeably  to  their  practice,  in  appar« 
ently  similar  states  of  disease.  Can  this  be  accounted  for  upon 
any  principle,  but  the  known  fact,  that  the  poorer  inhabitapts 
of  Europe,  among  whom  diseases  are  most  prevalent  when  they 
are  epidemic,  are  generally  supported  with  food  less  nutritious, 
than  the  Americans  ?  The  first,  with  their  lax  fibres,  assume, 
when  attacked  with  febrile  diseases,  that  typhoid  form,  which 
requires  tonics  and  stimulants ;  which  experience  proves  to  be 
inadmissible,  in  states  of  disease,  apparently  similar,  among  t^e 
well  fed  inhabitants  of  the  United  States.  And  where  astrin- 
gents and  bitters  are  required,  the  indigenous  proiluctions  of 
our  own  soil  being  fresh,  are  not  less  efficacious  than  exotics^ 

•^AKhern  rrontiera,  as  a  combination  of  ipecacuanha  and  opium,  in  the  form 
of  Dovaa's  powder.  Tbio  has  been  before  noticed,  in  the  preceding  Sketch- 
es, to  which  the  reader  is  referred. 

*      ff 

*  The  fatal  effects  of  astringents  during  the  war  were  often  demonstra- 
ted ;  especially,  when  evacuations  were  suddenly  checlced  by  thur  use, 
When  men  were  exposed  to  cold  and  moisture.  These  effects  were  most  con- 
spicuous, after  the  employment  of  acetite  of  lead.  Cases  in  the  foregoing 
Sketches  are  evidence  convincing,  without  retorting  to  argumentath'c  cJu- 
eidatioD,  to  shew  the  manner,  by  which  the  injurious  effects  were  proiJuceJ. 


I  I 


APPENDIX. 


30  r 


Ibund  in  the  itorei  of  druggists,  lut^jf^ct  to  dnmage  and  comip- 
tion,  by  which  their  virtues  are  either  destroyed  or  impaired. 

7ih.  J)illusiv«  stimulants  perhaps,  are  in  more  general  use 
among  the  iiihubitants,  than  any  article  of  the  materia  medica, 
fvhcn  Ihey  are  first  seized  with  (iiese  complaints  of  the  bowels. 
In  all  complaints  o(  this  description,  ardent  spiritr  bre  first  re- 
sorted to  oy  the-  ignorant ;  these  itotent  stimulants  are  also  di- 
rected by  those  who  prorets  to  be  wibe.  We  cannot  deny,  a 
disease  caused  by  an  extremely  high  degree  of  morbid  exciting 
powers,  may  be  subdued  by  active  stimulants.  But  this  favora- 
ble  event  is  too  sehlom,  to  warrant  our  indiscriminate  recom- 
mendation of  them.  The  Ingenious  speculations  of  Brown,  in 
some  measure,  introduced  the  high  stimulant  plan  of  ol/etiiffiii^ 
la  cure  diseases,  to  the  notice  of  physicians.  His  bold  un(|uali- 
fied  assertion,  that  ninety-eight  out  of  an  hundred  cases,  requir- 
ed stimulHuts,  is  not  only  imposing  and  pletising  to  us,  circum- 
srriDed  as  our  knowledge  of  the  states  of  diseases  is,  but  is  a 
subterfuge  for  ignorance ;  because  if  stimulants  were  prescribed 
in  every  case,  were  the  position  true,  the  prescribing  physiciaa 
could  not  err  bui  twice,  in  one  hundred  cases.  It  had  been  be- 
lieved, the  stimulant  plan  recommended  by  BaowN,  was  goin^ 
out  of  practice.*  .ti    •    ;•  ,  r 

Sydenham,  however,  has  left  on  record,  he  cured  at  one  pe- 
riod, dysentery  by  opium.  In  this  instance,  the  disease  appear- 
ed probably,  more  under  the  form  of  diarrhoQa  or  lienteria,  thaa 
when  the  disease  was  considered  by  him,  as  the  fever  of  the  sea- 
son, turned  in  upon  the  bowels ;  in  which  he  urged  the  necessi- 
ty of  evacuating  the  alimentary  canal,  previous  to  the  employ- 
ment of  slimulaiits  or  anodynes.  In  chronic  complaints  of  the 
bowels,  in  arn^y  practice,  opium  was  indispensable,  as  well  as 
ardent  spirits  diluted,  but  in  moderate  quantity. 


*  It  has  lately  been  revived  in  the  New-England  States,  to  a  degree  which 
i^  aitonishing.  TIjo  glass  doses  of  Brown,  in  con8e4uence  of  want  of  suc- 
cess, have  been  by  the  wi«e  Mieulapeana,  increased  to  pint  doiea.  Still  with 
all  this  improvement,  death  closed  the  scene.  The  physicians,  although 
fairly  beaten,  acquired  high  degrees  of  honor,  by  th«ir  perseverance,  and 
courageously  fighting  their  foe,  to  the  last  breath.  '; ».  .  /iR 

39 


Tf' 


,  ,w^  . 


062 


APPENDIX. 


I;    I 


8th.  MosBLET  believed,  the  mtitter  or  perspiration,  throim 
Uiion  the  intestines,  in  consequence  of  oltstruction  on  the  sur- 
face of  the  hiidy,  is  the  cause  of  dysentery  ;  and  conceived  by 
returning  it  bacic  to  the  skin,  its  natural  channel,  the  disease  is 
readily  removed.  After  bleeding,  and  evacuations  by  emetics 
and  cathartics,  he  depended  on  sudorifics  to  complete  the  cure. 
With  this  intention  "laudanum  and  antimonial  wine''  were  re- 
commended, "  as  a  pleasant,  and  certain  diaphoretic."  Jamrs^ 
powder,  he  says,  is  admirably  calculated  to  answer  the  above 
intention.  If  the  disease  continues  obstinate,  repeated  vomits 
of  ipecacuanha  are  given,  to  divert  the  blood  from  the  intestines, 
and  force  it  to  the  surface  of  the  body.  Let  \t  be  here  observ- 
ed, that  however  correct  Moseley's  practice  might  be,  yet  it 
does  not  follow,  that  obstructed  perspiration  is  the  cause  of  dys- 
entery. And  inasmuch  as  an  evacuation  from  one  part  will  re- 
move inflammation  from  one  remote  by  revulsion,  or  by  ab- 
sorption ;  such  evacuation  should  be  promoted,  not  however  from 
a  belief  that  obstructed  perspiration  is  the  cause,  but  an  effect, 
which  should  be  obviated,  to  expedite  the  cure  of  this  disease. 
Dysenteric  patients  therefore,  should  not  be  exposed  to  currents 
of  air,  or  cold,  but  coniined  in  situations  favorable  to  promote 
perspiration.  -.  /      '     ■ 

9th.  "  In  chronic  dysentery,  and  |>erverse  diarrhea,  which  may 
occur  in  practice  ;  from  errors,  want  of  skillful  advice  and  con- 
veniences," MoBELEY  gives  a  formula,  composed  of  sulphate  of 
zinc  and  alum,  which  may  be  found  in  his  treatise  on  tropical 
diseases.  The  quantities  of  the  vitriol  and  alum,  are  varied  in 
;he  prescription,  as  their  restrictive  or  evacuating  properties  ar*? 
required.* 

lOlh.  Dysenteric  patients,  where  their  diseases  are  chronic, 
and  obstinately  resist  common  remedies,  have  been  benefitted, 
if  not  cured  by  flannel  waistcoats  next  the  skin ;  and  they  be- 
come more  important,  when  the  disease  continues  into  winter ; 

*  'Ihi«  vitriolic  preparatiun,  was  re])eatedly  tried  in  army  and  hospital 
practice,  on  the  northern  fro'  icrs,  without  apparcjit  benefit ;  still  we  have 
'cason  to  believe,  ander  some  circumstances,  it  is  a  valuable  medicine  in 
these  chronic  diseases  of  the  bowels.  "     '■■'  -    >  v>^«  .„.j,^j    ,„.„..,^^^^;.,: 


1:1 


APPENDIX. 


C03 


fvhen  every  mean  should  be  employed,  to  supnort  the  action  of 
the  extreme  vessels,  by  retaining  (he  caloric  of  the  body,  and 
obviating  its  evaporation  upon  the  surfHce. 

11th.  A  change  of  climate  becomes  necessary  sometimes,  to 
cure  chronic  dysenteries  aud  diarrhoeas.  Invalids  in  the  West* 
Indies,  have  been  frequently  advised  to  remove  to  the  enstern 
states  of  America,  to  re-establish  health.  It  has  been  observed, 
when  these  convalescents  do  not  arrive,  until  the  setting  in  of 
frost  in  autumn,  their  complaints  deteriorate,  or  continue  through 
the  cold  of  winter,  until  the  warmth  of  summer  commences.  As 
our  cold  latitudes  prevent  the  necessary  action  u|ion  the  skin, 
and  a  general  healthy  excitement,  warmer  latitudes  are  to  be 
preferred. 

12th.  When  diarrhoeas  become  chronic  in  our  climate,  and 
obstinately  resist  remedies,  until  autumn  commences ;  the  pap 
tients  have  been  benefitted  by  a  change,  either  to  southern  lat- 
itudes of  the  United  States,  or  the  West-Indies. 

13th.  Too  much  attention  <'.annot  be  paid  to  cleanliness  in  all 
diseases,  more  especially  in  this,  which,  from  its  nature,  is  pe- 
culiarly offensive.  Excrementitious  materials,  should  be  imme- 
diately removed  from  the  sick  room.  When  it  is  apprehended 
that  a  prevalent  disease  might  have  originated,  or  been  aggra- 
vated by  materials  in  a  state  of  putrefaction,^  the  offensive  articles 
should  be  immediately  removed  from  the  vicinity  of  d\vellings, 
or  covered  with  earth ;  and  if  from  neglect  of  domestic  ablutions 
and  purifications,  '^  recourse  should  be  had  to  means  well  known 
to  every  wash-woman,  but  too  little  practised  by  a  large  propor^ 
tiou  of  mankind ;  viz.  a  liberal  ut>e  of  water,  soap  and  lime." 


CONCLUSION.  ^ 

From  the  earliest  ages  of  antiquity,  physicians  liave  beeu 
searching  after  specifics  to  cure  all  diseases.  Some  have  flatter- 
ed themb.  'ves,  every  disease,  to  which  the  human  body  is  lia- 
ble, has  either  upon  the  surface  of  the  globe,  or  concealed  with- 
in its  bowels,  an  antidote ;  while  others  have  believed,  there 
existed  under  some  form,  an  universal  medicine;  which,  as  with 
a  charm,  possessed  the  wonderful  power,  not  only  of  removiuo; 


'!•  ! 


T^ 


1 , 


U 


004 


APPENDIX. 


infirmities  accompanying  diseaBes,  but  the  imbeGilities  peculiar 
to  old  age.  '^   '  ' 

That  medical  enthasiasts,  and  pretenders  or  the  healing  art, 
should  have  frequently  imposed  upon  the  credulous  their  specif- 
ics, for  the  cure  of  diseases,  which  experience  proves  to  be  a  de^ 
ception,  is  not  a  passing  strange  event ;  but,  that  mankind,  not 
satisfied  with  having  paid  one  tax  on  account  of  their  credulity, 
should,  at  this  more  enlightened  period  of  the  arts  and  sciences, 
suffer  many  to  be  extorted  by  artful  impostors,  is  truly  won- 
derful. 

The  name  of  a  disease,  by  the  scientinc  physician,  is  less  at- 
tended to,  while  making  his  prescriptions,  than  the  state ;  while 
experience  evinces,  that  a  specific  does  scarcely  exist ;  and 
a  medicine,  possessing  the  powers  to  cure  aU  diseases,  is  a  mere 
fancy  of  an  extravagant  imagination. 

The  various  states  of  excitability^  to  which  the  human  system 
is  subjected,  in  consequence  of  the  variableness  in  the  season?, 
of  age  and  temperament,  evince  this  incontrovertible  truth,  that 
the  same  exciting  powers,  are  not  adapted  to  every  existing 
state  of  distise.  A  general  knowledge  of  the  above  physiolog- 
ical fact,  may  prevent  imi)Ositions  from  those,  who  deal  in  spe> 
eifics  and  catholicons ;  as  well  as  ensure  a  more  judicious  praor 
tice,  from  the  honestly  disposed  physician. 


'^li. 


.('* 


>i      -  -   5.: 


i'^;..!'  i>- ,'" 


'.  ••> 


,)     .  ,1.,;;,      i  .  ■■    •    .'.  >v,tw,-,^;  ni,    jf- 


,,,   !,„^,;:,   ''.».^  "' 


iv-U  .-  :  'u-    /: 


i.'HU-i.'rie.i^ 


^m- 


WINTER  EPIDEMIC  OF  1815-16. 


'*-. 


•■»  ^-Ti 


V    , 


ivi>imii    \iht"->  J.ff »/>■■'■".    *'■■>.;?  V 


An  epidemic  peripneumonia  notha  prevailed  during  part  of 
the  month  of  February,  March,  and  into  April,  in  the  town  of 
Sharon,  County  of  Norfolk,  twenty  miles  southerly  from  Boston ; 
"where  in  the  course  of  ten  days,  eighteen  persons  out  of  the  first 
twenty-four  cases  of  the  disease  died.  In  consequence  of  the 
alarm  given  by  this  uncommon  mortality,  I  was  invited  to  attend 
the  sick.  During  my  stay  of  sixteen  days  in  the  town,  I  visited 
between  sixty  and  seventy  patients,  who  were  attacked  with 
this  malady ;  of  whom  three  died,  one  of  eighty-two,  one  of  sev- 
enty-two, and  one  of  sixty-two  years  of  age.  The  following  ex- 
tract of  a  letter  which  appeared  in  the  Boston  Pateiot,  and 
Dailt  Advertiser,  is  expressive  of  the  opinion,  which  the 
inhabitants  of  the  town  of  Sharon  possessed,  respecting  the  prac- 
tice which  was  adopted  by  myself,  in  that  complaint.    .   , 

"  Through  the  medium  of  your  paper,  we  wish  to  express  our 
full  satisfaction  of  Doctor  Mann's  practice ;  believing  as  we  do, 
that  he  is  as  well  qualified  to  combat  the  mortal  effects  of  this 
disease,  as  any  physician  within  the  circle  of  our  knowledge." 

*'  It  is  our  wish,  he  would  lay  before  the  public,  the  nature  of 
this  disease,  which  has  appeared  to  confound  and  distract  many ; 
while  his  method  of  practice,  different  in  many  respects  from 
what  had  been  pursued,  might  be  a  mean  of  saving  many  valua- 
ble lives." 


(Signed)  ENOCH  HEWInS,  Jun. 

JOHN  MORSB, 

BENJAMIN  RAYNOLDS, 
•i     ,,»v        "      JOHN  SAVELS, 

OLIVER  WILLIAMS, 

JONATHAN  COBB, 
"      •  RANSLE  JONES, 

J'iim  WTTEE. 


.   } 


Selectmen  ef  Sharon 


LEWIS  MORSE, 
AARON  FISHER, 
JOSEPH  MORSE, 
ELIJAH  HEWWS,  Jo). 


TP 


306 


WINTER  EPIDEMIC  OP  1815-16. 


I     i 


l(  f 


Mi 


m 


V 


In  the  same  paper,  notice  was  given,  that  in  compliance  with 
(he  request  of  the  gentlemen  or  the  town  of  Sharon,  it  was  my 
intention  to  give  to  the  public,  a  statement  of  the  prevalent  epi- 
demic, ay  it  appeared  at  that  place,  under  its  various  forms,  with 
the  most  successful  method  of  practice  pursued.  After  exhibit* 
ing  my  general  practice,  it  was  observed,  I  had  never  seen  the 
peripmumonia  notha,  as  an  epidemic  in  this  section  of  New-Eng- 
land, until  1  saw  the  disease  at  Sharon  ;  that  sporadic  cases  of 
this  disease  sometimes  occur  on  the  aged  and  infirm,  during  pe- 
riods of  pneumonic  disorders ;  that  about  fifty  years  ago,  a  simi- 
lar disease,  which  proved  very  mortal,  appeared  in  the  upper 
towns  of  Norfolk,  and  adjacent  towns  in  the  county  of  Bristol  j 
and  that  many  physicians  have  seemed  (orun  wild,  with  appear- 
ances of  new  diseases. 

Hence,  we  find  diseases  at  the  present  day,  descril)ed  under 
new  names;  which  are  calculated  to  seduce  the  young  practi- 
tioner, from  a  correct  and  established  practice.  It  is  true,  that 
im[)rovemeul3  have  been  made  in  the  science  of  medicine ;  but 
it  requires  a  discriminating  mind,  and  an  extensive  knowledge 
of  ancient  as  well  as  modern  authors,  so  to  apply  these  improve- 
ments, OS  to  be  able  to  meet  diseases,  in  all  their  varying  shapes, 
^hich  they  assume  in  the  routine  of  years. 'Mf'  ?  •  'V«? 

A  student  of  the  present  day,  may  mdke  himself  well  acquaint- 
ed with  the  prevailing  diseases  of  his  time,  by  a  little  reading, 
and  an  extensive  practice  under  a  judicious  physician;  but 
vrithout  an  extensive  knowledge  of  books,  can  lie  be  prepared 
to  prescribe  with  the  best  effects,  to  a  disease,  the  form  of  which 
he  has  never  seen,  and  of  Avhich  he  has  little  or  no  knowledge, 
by  the  aid  of  medical  books  ? 

For  instance,  the  spotted  fever,  when  it  first  appeared,  was 
considered  a  novel  disease.  It  is  not  a  new  disease  under  the 
sun.  Various  remedies  were  prescribed,  by  the  most  judicious, 
before  a  permanent  efficient  practice  was  adopted.  After  the  spot- 
ted fever  had  its  mortal  race  a  few  years,  at  its  heel,  appeared  the 
peripneumonia  notha,  no  less  formidable  in  various  places  on  the 
northern  frontiers,  during  the  winters  of  1812-13-14,  not  only 
among  the  troops,  but  with  equal  morlaJHtf  over  an  extensive 


l.i^t    ti  *    .-•-!».• 


WINTER  EPIDEMIC  OP  1815-10. 


307 


district  of  country  among  the  citizens,  in  ttie  states  or  Ncw-Tork, 
Connecticut,  Massachusetts,  Vermont  and  Ne\?-Hain|)shire ; 
and  where  these  two  formidable  disorders  were  frequently  con- 
founded  with  each  other. — From  the  sudden  deaths  which  oc- 
curred, and  the  general  fatal  tendency  of  the  last  disease,  physi- 
cians conceived  it  wac  typhoid,  or  a  disease  of  debility ;  whence 
ardent  spirits  and  wine  were  resorted  to  as  remedies.  Indeed, 
when  ihe  peripneumonia  notha  first  appeared  at  Burlington,  Ver- 
mont, and  its  vicinty,  in  18 1 2-13,  it  was  viewed  and  treated  by 
some,  as  that  form  of  disease  called  spotted  fever  had  been.  By 
the  last  name,  the  pneumonic  epidemic  of  the  last  winter,  in  somo 
parts  of  the  counties  of  Norfolk  and  Bristol,  has  been  called; 
especially  where  it  has  proved  mortal;  for  every  mortal  disease, 
whether  necessarily  mortal  from  its  nature,  or  bad  management, 
must  have  attached  to  it  some  terrijic  name ;  and  since  spotted 
fever  has  become  a  fashionable  frightful  disease,  the  old  and  more 
common  terrifc  term  mah  snant  is  laid  u|)  for  future  use ;  but  how 
soon  it  may  again  be  ordered  into  service,  time,  which  changes 
the  fashion  of  names,  as  well  as  things,  will  only  disclose. 

This  a&me  peripneumonia  notha,  has  also  attached  to  it  in  some 
places,  the  additional  terrible  name  cold  plague ;  in  consequence 
of  a  torpor  and  coldness,  which  accompanies  its  first  attack. 
Thus  this  disease  commenced  its  first  onset,  in  Attkborough, 
Matutfield,  Wrentham,  Sharon,  &c.       ■  * '  ■»  / -i"-    • s       '•  *"  v 

Thus  we  perceive,  a  formidable  name,  in  many  instance!?, 
instrumental  of  introducing  an  incorrect  practice,  to  the  no  smalt 
discredit  of  the  medical  profession ;  and  this  will  ever  be  the 
case,  while  physicians  administer  to  natnes,  rather  than  the  symp- 
toms and  states  of  disease.  "-  ■ 

In  some  places,  profuse  sweatings  have  been  resorted  to,  in 
the  first  attack  of  this  disease.  If  any  have  been  so  fortunate 
as  to  pass  through  this  mode  of  practice,  in  addition  to  the  wei;r|]t 
of  disease,  they  have  abundant  reason  to  bless  their  strength  of 
constitution,  net  their  prescribing  physicians.  I  have  the  fullest 
evidence  to  convince  myself,  that  many  have  succumbed  under 
this  absurd  practice.  Some  probably  have  survived  tliis  violent 
process,  as  well  as  the  more  stimulating  practice  of  ardent  spir^ 


T^ 


SOS 


WINTER  EPIDEMIC  OP  1815-16. 


i 


ll 


VI 


I    \ 


I  I 


its,  by  pints  and  quarts ;  their  number  however,  hre  too  few  to 
induce  a  belief,  that  these  irregular  means,  are  the  most  eligible 
remedies.  ititui^i  i.i'ix  muiU  .•»;  ^^Lir  Im<> 

As  this  disease  is  nearly  allied  to  the  more  common  disease, 
denominated  pleurisy  ;  bleeding,  was,  in  some  instances,  india- 
criminately  resorted  tp,  at  Wa  first  attack,  in  connection  with 
stimulants ;  but  as  death  too  frequently  followed  this  irregular 
practice,  it  was  rejected  as  a  deadly  practice,  in  toto.  Almost 
every  potent  remedy  has  had  its  day  of  trial,  in  this  epidemic ; 
and  in  their  turn,  have  been  indiscriminately  condemned. 
Whereas,  many  of  those,  excepting  profuse  sweatings,  and  ar- 
dent spirits,  may  be  not  only  suitable,  but  necessary,  in  some  of 
the  forms  of  this  disease ;  while  the  success  of  their  different  ad- 
ministrations, depends  altogether  upon  the  ages,  constitutions, 
temperaments,  and  habits  of  the  patients.  "•  -     "      -f" 

At  Sharony  the  peripneumonia  nolha  made  its  first  attack,  with 
symptoms  of  uncommon  coldne^.d  and  torpor,  which  pervaded 
the  whole  system,  without  those  strong  rigors  observed  in  pleu- 
risy, and  intermittent  fever;  the  heat  of  the  body  at  the  same 
time,  to  the  touch,  much  below  the  standard  of  health.  During 
the  state  of  torpor,  an  oppressed  respiration  supervened,  accom- 
panied with  i>ain  in  one  side,  which  increased,  as  the  paroxism 
of  fever  came  on.  The  heat  of  the  botly  during  the  febrile  stage, 
was  never  much  above  the  standard  of  health;  sometimes  the 
heat  did  not  appear  to  be  higher  in  degree  than  natural.  The 
pulse  during  the  cold  stage,  was  very  small ;  and  somewhat  ful>- 
ler  than  natural,  during  the  hot  stage ;  but  not  what  might  be 
denomiuatod  a  hard  full  pulse,  except  in  two  or  three  instances, 
in  very  robust  constitutions.  There  was  a  remarkable  pale  pink 
coloured  suii'usion  over  the  ^vhole  face,  distinct  from  the  usual 
i'ehrile  blush  in  the  cheeks  ;  the  appearance  was  similar  to  the 
sudden  flush  colour,  produced  by  silting  before  a  fire,  after  hav- 
ing been  exposed  to  cold.  This  appearance  was  most  conspic- 
uous on  persons  having  ,fair  and  light  complexions.  This  was 
accompanied  with  a  bloated  countenance,  which  gave  to  the 
spare  and  (lale-faced  patient,  additional  beauty  to  the  general 
features.     This  roiige>like  appearance,  was  less  conspicuous  oa 


WINTER  EPIDEMIC  OP  1315-10. 


309 


Ihe  body,  Ihan  the  face.     A  cough  supervened,  after  the  first 
twenty-four  hours,  in  some  instances  ;  and   when  it  was  iiccom- 
panied  with  an  expecluratioM,  the  pain  in  the  side  abated;  but 
if  no  expectoration   accompanied  the  couj^h,  all   the  dangerous 
aymptoms  were  aggravated.     The  expectoration  was  dilTerent, 
according  to  tlie  degrees  of  danger.     The  matter  expectorated, 
did  not  appear  like  common  mucus  ;  but  more  similar  to  lympli, 
intimately  tinged  or  tinctured  with  blood,  varying  its  hue  in 
ditTerent  subjects.     Sometimes  the  expectoration  was  ash-col- 
•ured,  or  dark  brown  ;  in  a  few  cases,  it  was  a  simple  plilegm. 
The  tongue,  the  first  twenty-four  hours,  assumed  a  very  foul  ap- 
pearance, from  a  thick  yellow  fur,  to  a  dark  brown  colour.    The 
dark  coloured  tongues,  wore  dry,  hard,  and  rough ;  and  on  tho 
second  day,  appeared  lilce  the  dark  furred  tongues  of  those,  who 
have  been  sick  with  typhous  fever  a  fortnight ;  when,  after  the 
fur  separated,  or  sloughed  off,  the  tongue  appeared  of  strawberry, 
or  cranberry  red,  as  did  the  fauces.     It  is  to  be  noticed,   that 
during  the  cold  stage,  the  patients  suffered  from  pain  throughout; 
the  muscles  of  the  body,  in  one  case  similar  to  rheumatism.     la 
four  or  five  instances,  this  epidemic  made  its  assault  upon  the 
head ;  which  bleeding  immediately  relieved ;  upon  enquiry,  E 
found  there  was  here  no  complaint  whatever  within  the  chest. 
It  was  then  prognosticated,  that  in  twenty-four  houra,  more  or 
less  disease  would  exhibit  itself  on  the  lungs.     This  prediction, 
which  was  presumed  upon  former  experience,  on  the  northera 
frontiers,  was  fulfilled  in  every  instance  where  made ;  while  the 
pneumonic  symptoms  which  followed,  were  not  eventually  less 
severe,  than  in  those  cases,  where  the  first  symptoms  of  disease 
shewed  themselves,  within  the  breast.   '    .    . 

There  were  three  among  seventy  or  more  sick,  not  marked 
with  characteristic  symptoms  of  the  epidemic,  which  assumed 
the  form  of  genuine  erysipelas  ;  where  the  iofiammation,  in  one 
instance,  pervaded  successively  every  part  of  the  body.  These 
forms  of  disease,  were  unaccompanied  with  any  pneumonic  af- 
fection ;  but  required  the  general  remedies  employed  in  that 
oomplaiat. 

This  disease  was  not  coDtiaed  to  any  age  j  upoa  those  over 
40 


▼  ' 


V 


II 


dio 


WINTER  EPIDEMIC  OP  181 5-1  ft 


i 


II  r 


iir 


fifty  ye<irs,  it  w»  t  most  severe ;  it  appeared  on  those  UDder  teo 
years  of  age,  as  a  common  pneumonia.  A  similar  disease  pre' 
Vailed  in  some  or  the  neighbouring  towns,  during  the  wintei^ 
mouths ;  and  in  the  town  of  AttUborous^h,  distant  fifteen  miles 
from  Sharon ;  more  than  one  hundred  died  with  this  epidemic^ 
in  the  course  of  three  monthst 

The  weather  during  the  past  winter  was  very  changeable. 
After  a  very  cold  period  in  the  month  of  January,  and  during 
part  of  the  month  of  February,  the  transition  from  cold  to  very 
warm,  was  sudden.  This  month  anticipated  spring,  so  as  ta 
dissolve  the  ice  in  the  fresh  ponds  in  the  country.  The  change 
again  was  so  great  in  the  month  of  March,  from  very  pleasant 
to  severe  cold,  that  these  ponds  were  again  frozen ;  and  during 
the  last  month,  the  daily  transitions  of  weather  were  great ;  and 
these  sudden  variations  continued  into  May.  These  transitions 
are  believed  to  have  been  one  cause  of  this  epidemic.  To 
search  for  remote  predisponent  causes,  floating  on  the  wings  of 
the  wind,  is  like  buildi  ig  castles  in  the  air.  Atmospheric  influ- 
ences, independent  of  hot  and  dry,  cold  and  wet,  are  out  of  the 
bounds  of  our  circumscribed  knowledge  j  and  were  we  able  to 
comprehend  their  nature,  could  we  by  any  means  control  their 
powers,  so  as  to  obviate,  their  effects  upon  the  human  conslito* 


tion? 


-J.'   ;'....,- ■(T«i,.vyi.), 


4>V     .1 


*f  -^ :»-.>« Vj-'r  iritf'r.-.(tl/.1;t 


While  the  animal  creation  is  fortified  by  nature,  against  the 
Varying  seasons,  and  more  sudden  transitions  of  weather ;  man 
is  endowed  with  reason  to  direct  him,  how  to  avoid  their  dele- 
terious effects.  This  first  gift  of  heaven  will  not  be  improved  to 
-secure  his  health,  while  he  erroneoraly  believes,  that  occult 
agents  are  the  sole  causes  of  disease.  Natural  evil  is  so  inti- 
mately connected  with  moral,  to  obviate  the  first,  man  should 
shim  ihe  lasL  No  species  of  irregularity,  predisposes  the  body 
to  tlisease,  in  so  high  degrees,  as  an  intemperate  \ite  of  ardent 
spirits ;  while,  during  periods  of  epidemic  diseasss,  these  exciting 
liquors  are  swallowed  by  those  ignorant  of  their  dangerous  ten- 
dency, in  still  greater  profusion,  as  a  mean  to  obviate  those 
very  ;;  eases,  which  ihey  often  generate,  or  excite  to  states  of 
excessive  danger.    .Cne  of  the  most  effectual  means,  to  secar« 


WINTER  EPIDEMIC  OP  1815-1§. 


91t 


Hie  body  against  all  our  vrioter  epidemic*,  is  warm  clothing ; 
and  could  the  inhabitants  or  New-England,  but  he  made  sensi- 
ble, that  ardent  «i)irits  do  not  protect  the  body  Trom  diseases  of 
any  kind;  and  would  they  adopt  a  firm  resolution,  to  drink  none 
of  these  stimulating  liquors,  and  place  the  value  usually  con- 
•umed,  in  woollen  or  flannel  garments  upon  their  iKMltes,  they 
would,  when  they  settle  their  annual  accounts,  find  themselves 
not  only  richer  *n  the  means  to  render  themselves  happy,  hut 
abounding  in  health;  the  greatest  blessing  which  man  can  po6» 
sess  on  earth. 

Vicious  habits  once  confirmed,  are  with  difficulty  overcome; 
but  however  bad,  they  may  be  conquered  by  persevering  reso* 
lulion.  Those,  who  have  been  in  the  intemperate  use  of  ardent 
spirits,  experience  a  sinking  sensation  at  the  stomach,  when  they 
abstain  from  these  liquors;  which  discourages  them  in  their 
first  attempts  to  reform.  The  stimulating  eflecis  of  ardent  spir- 
its, are  of  short  duration ;  while  the  debility  induced,  renders 
the  subjects  of  intemperance  nut  less,  but  more  susceptive  of 
oold. 

To  cure  intemperance,  the  patient  may  advantageously  drink 
sweetened  water,  charged  with  ginger  or  red  pep|)er ;  in  the 
pro|)ortion  of  a  table-spoonful  of  the  first,  or  a  tea-spoonful  of  the 
last,  to  a  pint  of  water.  When  the  above  liquor  is  drank  to  re- 
sist cold,  it  should  be  taken  into  the  stomach  milk  warm  ;  and 
where  it  is  advised  to  old  inebriates,  the  water  should  be  as  high* 
ly  impregnated  with  the  pepper,  as  can  be  borne  on  the  stomach. 

Much  experience  has  convinced  me,  that  nothing  fortifies  the 
body  to  endure  severe  cold  so  long,  as  strong  coSee,  with  a  small 
quantity  of  animal  food.  The  writer  of  this,  has  repeatedly 
rode  on  horse'flick  fifty  miles,  in  a  cold  Avinter's  day,  without 
taking  into  his  stomach  any  stimulating  article,  except  hot  cof- 
f«e,  and  a  piece  of  bread  and  meat.  With  this  stimulus  alone, 
be  was  rendered  capable  of  enduring  the  severest  cold  of  a 
northern  climate,  three  hours,  with  little  inconvenience.  Where 
circumstances  do  not  admit  of  the  benefit  of  coffee  beverage,  the 
ginger  and  pepper  drink  may  be  equally  beneficial,  taken  witli 
some  animal  nutriment ;  and  pe.'haps  more  useful  than  cof^eOfi^jf 
^osb'  habituated  U)  tbe  stimulut  of  ardeat  spirits. 


312 


WINTER  EPIDEMIC  OP  1816-16. 


^liihi 


Amon;;  llie  means  BiMt  effccfivc,  to  secure  Iho  Imdy  frord  at- 
taekf  of  inrentiout  diaeaseB,  nre  clennlinens,  chrerralnrnfl,  mid  rt 
Hoft  nufritioiis  diet.  Pear,  drnpondrnry,  fatipie,  and  long  watch- 
Jr»js,  co-operate  with  hiirlful  agents,  to  pr«)diicc  diseiine.  When 
n  violent  disease  nRsails  one  menil»er  of  a  family,  and  otiiers  in 
the  same  dwelling  .ire  taken  down,  ,1  is  often  apprehended  the 
iliseaae  is  contagious.  The  sick  are  shunned  by  friends,  and 
nssistancc  is  with  difliculty  procured.  Hence,  during;  opidemicr. 
Ihe  diseased,  who  might  have  been  preserved  by  suitable  meanf . 
]icrish  ;  while  the  general  and  local  causes  of  the  disease,  as  pu- 
trid effluvia,  transitions  of  weather,  &c.  co-opernte  with  the  fac- 
titious, to  induce  on  each  individual,  a  similar  disease.  I  oner 
predicted,  that  n  family  would  be  invaded  by  disease.  The 
precaution  was  aug^ested,  to  induce  a  removal  of  filth,  which 
incommoded  their  habitation,  during  the  hot  season.  PrcviouF 
to  the  expiration  of  four  weeka,  my  prognostication  was  verified, 
l)y  the  appearance  of  a  typhous  fever,  tvhich  seized  succeBsivelr 
the  whole  family.  In  this  instance,  as  in  similar  occurrences, 
a  belief  existed,  that  the  fever  was  contagious,  and  communica- 
ted from  one  to  others.  Tlie  truth  was,  as  all  were  subjected 
1o  the  ger^rating  cause  of  the  disease,  the  surrounding  filth,  so 
all  were  infected.         •*>^  ■">.**•:■  *,'^  ^.  v  ■■i.t-;,;  .><■ 

During  periods  of  epidemic  disorders,  every  irregularity,  ca- 
pable of  exciting  disorder  in  the  system,  will  produce  a  disease, 
correspondent  with  that  form  of  fever  most  prevalent.  This  of 
itself  is  evidence,  that  during  these  states,  more  or  less  predis- 
position to  disease,  exists  within  the  human  system,  even  when 
n  person  appears  in  perfect  health.  A  transition  from  high 
states  of  health,  to  severe  disease,  is  not  unfrequent,  sometimes 
vry  sudden;  and  a  disease  which  might  have  been  light,  pro- 
duced by  mere  atmospheric  influence,  may  become,  by  addi- 
tional exciting  causes,  extremely  dangerous.  The  scourge  of 
epidemics  may,  in  some  degree,  be  prevented,  by  protecting  the 
body  from  cold,  by  woollen  garments  next  t  le  skin  ;  by  a  rigid 
temperance  in  eating  and  drinking;  by  avoiding  excessive  fa- 
tigues and  watchings,  and  contaminated  air,  generated  in  small 
close  rooms,  by  an  assemblage  of  people ;  and  after  respiring 


"^  .,.- 


WINTER  EPIDEMIC  OF  181 5-1  tt. 


318 


tho  impare  nir  of  such  confined  roomi,  by  guardinf^  the  bodjr 
ngainst  nocturnal  exposures  to  culd.  Severe  attacki  of  epidem- 
ic discasrs  may  as  certainly  lie  obviated,  as  the  above  condi> 
lions  mny  be  avoided. 

At  liochester,  county  or  Plymouth,  there  were  eases  where  (he 
disease  was  not  confined  to  the  lungs  ;  but  the  inflammation  ap- 
peared under  the  form  of  cynanche  trachealis,  pharyngaa  and  pa- 
rotidaa,  as  the  trachea,  tonsils,  and  parotid  glans  were  succes- 
sively or  simultaneously  afTected.  Erratic  pains,  or  a  dry  cough 
were  noticed,  as  precursors  of  the  local  affection.  These  wand' 
ering  symptoms  did  not  alarm  thn  patients.  Tor  their  appetites 
were  not  impaired,  nor  were  their  strength  and  spirits  depressed. 
The  appetite  indeed  was  not  much  impaired  during  the  course 
of  the  disease.  No  permanent  relief  was  obtained,  until  a  free 
expectoration  supervened ;  and  where  there  was  no  expectora- 
tion under  severe  attacks,  the  patients  always  died.  i-  •      > 

This  disease  was  highly  inflammatory  from  its  commence- 
ment to  its  final  resolution.     It  was  as  idle  to  administer  stimu* 
laats  for  its  cure,  as  it  appeared  at  Sharon  and  Rochester,  as  it 
would  have  been  to  have  poured  oil  on  fire,  to  extinguish  the 
flame.     A  man  thirty  years  of  afje,  convalescing,  relapsed,  in 
consequence  of  taking  into  his  stomach   one  glass  of  brandy, 
with  symptoms  more  severe  than  the  first  attack  ;  from  which, 
by  mcnns  of  bleeding,  blistering  and  cathartics,  he  eventually 
recovered.     A  woman  forty  years  old,  was  indulged  in  half  a 
glass  of  wine    after  a  resolution  of  fever.     The  day  succeeding 
a  renewed  attack  of  pain  in  the  side,  laborious  respiration  and 
dry  cough  supervened  ;  when,  by  the  employment  of  expecto- 
rants, calomel,  tartrite  of  antimony,  and  an  emetic  of  ipecacuan- 
ha, expectoration  was  reproduced,  and  restoration  to  health.  A 
woman  past  sixty,  while  in  a  convalescent  state,  drank  some 
braady  diluted ;  in  a  few  hours,  expectoration  stopped,  succeed- 
ed by  pain  in  the  breast,  and  difficult  respiration.     This  case 
was  thought  extremely  dangerous.     By  the  employment  of  cal- 
omel, ipecacuanha,  blisters  on  the  chest,  an  expectoration  of 
bloody  mucus  returned ;  and  from  this  state,  a  slow  recovery  of 
health  followed.  i    ,v 


U' 


T^ 


su 


VINTER  EPIDEMIC  OP  1815-lflt* 


i 

1 


1'. 


V 


The  ntture  of  thh  iliscaie  wai  well  koown  to  me,  baring pfrnf' 
■cribed  for  it,  during;  the  winters  1812-13-14,  on  the  northern 
froBtien.  Many  diiiectiont  also  had  coafirmrd  me,  the  diteaa* 
was  inflammatory  in  the  highest  degrees ;  notwithstanding  all 
which  has  been  a<iduc«d  contrary  to  this  sentiment,  and  some 
symptoms  which  are  sometimes  noticed  in  typhous  states  of  h- 
v«r,  as  torpor,  coldness,  and  weak  pulse.  It  should  be  understood* 
that  notwithstanding  all  the  al»ovo  conditions,  the  most  promi- 
nent symptoms  or  typhous  fever  do  not  rxist  in  this  complaint ; 
as  debility  and  low  delirium.  In  n  very  few  instances,  delirium 
lias  accompanied  the  olher  symptoms  of  the  disease ;  but  it  is 
always  phrenetic.  In  most  cases,  where  patients  succumb  un- 
der the  disease,  they  die  in  strength.  This  was  remarkable  on 
the  frontiers.  They  wore  frequently  able  to  walk  the  room,  at 
the  moment  suifucation  took  place,  and  instantly  expired.  A 
case  of  the  List  de'^sription  appeared  at  Ilochester,'*county  of 
Plymouth,  in  the  month  of  April,  1810. 

It  is  known  to  physicians,  there  are  two  species  of  inflamma- 
tion, phlegmon  and  erisipelas.  The  first  is  accompanied  with 
stronger  arterial  action,  and  higher  degrees  of  heat  than  the  last. 
The  phlegmon  is  deep  seated ;  while  the  erisipelas  shews  itself 
in  the  skin,  and  sometimes  penetrates  to  the  subjacent  cellular 
membranes.  The  first  is  local,  while  the  general  heat  and  fe- 
ver is  the  consequence  of  association ;  the  last  more  diflused^ 
pervading  sometimes  the  whole  surface,  progressing  from  parts 
first  affected  to  others.  The  viscera  and  internal  parts  of  the 
body  are  subject  to  both  species  of  inflammation,  as  well  as  the 
surface.  The  epidemic  pneumoniaof  the  winter  1816-16,  ap- 
peared to  have  been  erisipelatous.  It  was  not  a  mere  local  af- 
fection at  itj  onset,  as  is  the  pleuritis  vera ;  all  the  membranous 
parts  partook  of  the  disease,  in  low  or  higher  degrees  ;  while  the 
lungs  RiOst  generally  suffered  in  the  highest.  The  scarlatina, 
which  was  a  compa'^ion  of  the  pneumonic  symptoms,  as  well  as 
a  few  cases  of  genuine  erisipelas,  favors  this  opinion. 

Stimulants,  excepting  warm  external  applications  and  mild 
tepid  drinks,  were  inadmissfblcj ;  these  were  employed  only  dur- 
Juig  the  cold  and  torpid  stage  of  the  disease ;  and  coutioued  n^ 


ti 


WINTER  EPIDEMIC  OP  1815-16. 


Sit 


fonder,  than  to  rettore  natural  heat.  The  cure  depended  upoo 
aitiduoui  adminiatration  of  the  antlphloglatlc  regimca ;  aYun- 
anta,  expectorants  and  diaphoretict,  with  the  aid  of  blUtera. 

Bleeding  was  considered  anning  the  Ant  remedlei ;  not  b»- 
enuie  it  wai  demanded  in  all  caiei,  but  the  first  in  order  where 
indicated.  It  could  not  be  dispensed  with  in  .nany  cases,  hut 
*^ould  in  no  instance  be  employed,  until  natural  beat  is  restor- 
ed; and  then  repeated  small  bleedinj^s  were  preferred  to  one  or 
two  large.  If  we  were  to  he  governed  by  proTessionHl  rules,  the 
pulse  seldom  indicated  the  eni|doym(*nt  of  the  lancet.  It  waa 
pain  and  laliorious  respiration  which  directed  its  use ;  while  *he 
practice  was  warranted  by  repeated  and  acknowledged  succ^  ^ 
which  followed  blood-letting.  In  most  olisiiniite  cases,  it  waa 
em|)loyed  two,  three  and  four  times  in  twenty-four  hours.  A 
practice  similar,  was  attended  with  the  best  eiTects,  during  the 
winters  1812-13-U,  on  the  northern  frontiers.  It  is  however 
to  be  observed,  fewer  cases  req'iired  bleeding  at  Sharon  and 
Rochester,  than  in  the  army,  and  the  reason  is  obvious.  In  ho» 
pital  practice,  its  beneficial  effects  were  more  evident ;  the  pa- 
tients were  continually  under  the  eye  of  the  surgeons,  who  im* 
proved  the  import  t  moment,  when  bleeding  was  most  necet< 
•ary.  In  country  practice,  where  patients  cannot  receive  a  vif 
it  only  once  in  twenty-four  hours,  the  favorable  period  forbleedf 
ing,  or  its  repetition  was  frequently  lost. 

At  Hharon,  out  of  sixty  cases,  seven  were  bled ;  those  wb^ 
were  bled,  recovered.  Tliree  who  were  advanced  in  yean, 
who  were  not  bled,  died.  At  Rochester,  twenty  out  of  near  sev- 
enty cases,  which  came  under  ray  observation,  were  bled ;  three 
of  whom  <Iied.  One  of  whom  was  bled  eight  ounces,  and  withia 
twenty-four  hours,  tool(  one  hundred  grains  of  calomel,  one  hund- 
red grains  of  jalap,  two  ounces  of  castor  oil,  and  four  ounces  of 
sulphate  of  soda,  all  of  which  produced  only  two  small  evacuationa. 
In  this  case,  the  lancet  was  timidly  employed.  The  rnun  waa 
very  robust ;  previous  to  the  disease,  for  a  length  of  time,  he 
had  been  in  the  daily  habit  of  drinking  a  pint  or  more  of  ardent 
spirits.  This  man  died  auflbcated,  while  walking  his  room. 
ThQ  two  others,  it  was  believed,  counteracted  the  bene&eial  tf 


/ 


1 


v^^^.-n.. 


"i-L.^^ 


316 


WINTER  EPIDEMIC  OP  181 5-1  d. 


.lit 


'. ;''     'I 


#■ 


fects  oT  remedies,  by  an  habitual  employment  of  opium ;  froH 
the  use  of  which,  they  would  not  be  restrained. 

It  was  most  evident,  th«  pulse  became  fuller,  and  heat  of  the 
body  increased  after  the  first  bleedings,  when  difficult  respira- 
tion abated.  If  this  most  dreaded  symptom  was  not  overcomo 
by  the  third,  fourth  or  fifth  day,  the  patient  died,  e-jfTocated ;  ia 
strength,  not  in  a  typhous  state  of  fever,  as  by  many  has  beea 

apprehended.  vy(,nv«wv,  r  i-'iif'st^-.i  rvn' 

rj,  The  internal  remedies  upon  which  moat  dependence  was  plac- 
ed  were  calomel  and  anlimonials.  These  were  repeated  in  do-^ 
ues,  every  two  or  three  hours,  so  as  to  prove  cathartic  within 
the  first  twenty-four  hours ;  and  if  not  effected  in  the  above 
time,  a  full  cathartic  of  calomel  and  jalap,  twenty  grains  eacli 
was  administered,  which  was  sometimes  repeated.  From  one 
to  five  grains  of  calomel,  and  from  ^  to  ^  of  tartrite  of  antimony 
were  continued  at  short  intervals,  until  a  resolution  of  fever  was 
effected.  The  commencement  of  which  was  known  by  a  free 
expectoration,  and  a  gentle  diaphoresis.  In  robust  habits,  dras- 
tic purges  were  occasionaUy  repeated  ;  in  less  robust,  cathartics 
of  sulphate  of  soda,  or  castor  oil,  fulfilled  the  intention.  Some- 
times ipecacuanha  was  combined  with  calomel  in  small  doses, 
-  instead  of  the  antimony  ;  especially  when  disposed  to  pass  off 
by  the  bowels.  -- 

.  In  most  severe  cases,  calomel  was  believed  of  so  much  im- 
portance, that  we  were  certain  to  etTect  a  cure,  when  a  sore 
mouth  was  produced  by  its  use. 

Emetics  were  not  administered  ml'J  after  bleeding  (where  ne- 
cessary,) and  cathartics  had  been  employed ;  especially  where 
the  head  or  breast  were  affected  with  severe  pain.  After  ex- 
pectoration had  supervened,  and  from  any  cause  it  stopped, 
small  emetics  of  ipecacuanha  were  found  beneficial,  while  their 
repetition  was  necessary.  This  seldom  failed  to  reproduce  ex- 
pectoration. In  apthous  state  of  fever,  ipecacuanha,  blood-root, 
and  ^encka  in  small  repeated  doses,  were  employed  with  advan- 
tage. ,^v  ■,'!  ff.  "-'.'iTr;  r  j4«t,:-''^f  i-  !  /-.'rv  '{;.■'■  ■.v  ;'  ^  rfc?  ?''^'^ 
u  Extensive  blisters  on  the  chest,  were  of  the  highest  impor^ 
tauce,  from  the  commencement  of  the  disease.    These,  in  ob- 


« 


WINTER  EPIDEMIC  OF  1815-16. 


317 


re  ne- 
Iwhere 
ler  ex- 
)pped, 
their 
;e  ei- 
l-root, 
idvaa- 


gtinate  eases,  were  daily  renewed  with  benefit ;  blister  succeed* 
ing  blister  on  the  side  and  breast,  until  pain  was  removed. 

Stimulants  of  ardent  spirits  or  vinous  liquors,  were  of  no  bene- 
fit  in  the  course  of  the  fever,  nor  even  durini;  conviilescency. 
The  oily  stimulus  employed  in  the  convalescent  state,  was  a 
mixture  of  spirits  of  nitre  dulcified,  and  water  of  volatile  ammo^ 
nia,  in  such  proportions  as  the  volatile  predominated.  A  tea* 
spoonful  of  this  compound,  proved  a  cordial  and  expectorant,  at 
the  termination  of  the  disease,  administered  once  in  three  or 
four  hours;  as  did  also  a  mixture  of  equal  parts  of  camphorated 
tincture  of  opium  and  antimonial  wiue,  where  a  cough  was  troub- 
lesome. .  . 

Opium  was  of  no  use  to  subdue  pain  in  the  disease  ;  it  was 
found  injurious  until  fever  was  overcome ;  comldned  sometimes 
either  with  calomel  or  ipecacuanha,  at  the  close  of  fever  to  allay 
cough,  it  was  advantageous. 

Relapses  have  succeeded  the  use  of  ardent  spirits  during  the 
state  of  convalescency.  These  stimulants,  in  every  instance 
where  employed  under  my  observation,  have  checked  that  ex- 
pectoration from  the  lungs,  which  is  so  necessary  to  complete  a 
resolution  of  the  disease,  and  which  was  considered  the  natural 
cure  of  that  formidable  epidemic.  Many  have  died  under  a 
stimulating  regimen,  which  had  been  adopted  at  the  commence- 
ment of  the  disease,  or  been  introduced  during  its  more  advan- 
ced stage ;  under  a  presumption,  the  disease  was  typhous,  or  had 
a  tendency  to  that  state.  Whereas,  when  the  disease  was  over- 
come by  the  antiphlogistic  practice,  the  appetite  returned  with- 
out  the  aid  of  excitements.  The  natural  stimulants  of  life  only 
were  necessary,  to  restore  health  and  give  strength. 
41 


impor- 
in  ob- 


T — :7^ 


il 


i'S  I 


ThefoHoivin^  public  approhalton  of  the  jmictkc  culoptcd  at  Roches- 
ter^  first  appeared  in  the  Ncn-Bedford  Mercury,  24th  May. 

A  CARD. 

To  Doctor  James  Mann,  ok  Boston.  "  , 

The  Subscribers,  inhabitants  of  the  town  of  Rochester, 
consider  it  a  d)i(y  (which  they  are  not  at  liberty  to  dispense 
with)  to  publicly  express  the  high  sense  they  have  of  the  ines- 
timable benefits  which  have  accrued  in  this  place  from  your  di- 
rections, prescriptions  and  applications,  in  your  late  visit  here, 
to  those  who  were  suffering  under  the  operation  of  a  most  ma- 
lignant epidemic  disorder,  (of  which  such  great  numbers  had 
died)  and  gratefully  to  express  to  you,  and  to  the  public,  that 
they  consider  you  (in  the  hand  of  Divine  Providence)  to  be  the 
happy  instrument  of  checking  the  fatal  progress  of  that  mortal 
distemper,  and  of  restoring  many  therefrom  to  health  ;  as  we  are 
convinced  (from  the  event)  that  your  system  of  practice  is  the 
best  calculated  of  any  that  we  know  of,  to  prevent  the  fatal  ef- 
fects of  said  distemper.  , 


NATHAN  JENNE, 
TIMOrHY  DAVIS, 
JOHN  CLARK, 


I 


Selectmen  of  Rochester, 


JESSE  HASKELL, 
ABRAHAM  HOLMES, 
ELISHA  RUGGLES, 
NATHANIEL  JlUtiGLES, 


LEMUEL  WINSLOW, 
timothy  HILLER, 
G.  n.  N.  HOLMES, 
NICAII  H.  HUGCLES, 


Kocliester,  May  20, 181C. 


k";  ,  H 1 


i  at  Rochcff- 
4th  May. 


OCHESTER, 

to  dispense 
)f  the  ines- 
)m  your  di- 
visit  here, 
a  most  ma- 
imbers  liad 
)ublic,  that 
)  to  be  the 
that  mortal 
J  as  we  are 
Jtice  is  the 
he  fatal  ef- 


hestcr, 


